Provider Demographics
NPI:1558072256
Name:JTC BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:JTC BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:IHUEZE
Authorized Official - Last Name:IHEOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-857-9193
Mailing Address - Street 1:8700 CENTRAL AVENUE
Mailing Address - Street 2:STE #300/#200B
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4853
Mailing Address - Country:US
Mailing Address - Phone:240-838-7068
Mailing Address - Fax:240-619-4916
Practice Address - Street 1:8700 CENTRAL AVENUE
Practice Address - Street 2:SUITE #300/#200B
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-4853
Practice Address - Country:US
Practice Address - Phone:240-838-7068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-13
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health