Provider Demographics
NPI:1609297837
Name:BURRIS BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:BURRIS BEHAVIORAL HEALTH LLC
Other - Org Name:RIVERSIDE COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:BURRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,LCPC
Authorized Official - Phone:410-935-1489
Mailing Address - Street 1:1200 BRASS MILL ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BELCAMP
Mailing Address - State:MD
Mailing Address - Zip Code:21017
Mailing Address - Country:US
Mailing Address - Phone:410-935-1489
Mailing Address - Fax:
Practice Address - Street 1:1200 BRASS MILL RD
Practice Address - Street 2:SUITE A
Practice Address - City:BELCAMP
Practice Address - State:MD
Practice Address - Zip Code:21017-1217
Practice Address - Country:US
Practice Address - Phone:410-935-1489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0372261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health