Provider Demographics
NPI:1609484039
Name:UNIQUE MINDS BEHAVIORAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:UNIQUE MINDS BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGANG
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:301-437-9937
Mailing Address - Street 1:6810 PARK HEIGHTS AVE # C6
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-1641
Mailing Address - Country:US
Mailing Address - Phone:443-538-8400
Mailing Address - Fax:
Practice Address - Street 1:6810 PARK HEIGHTS AVE # C6
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-1641
Practice Address - Country:US
Practice Address - Phone:443-538-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)