Provider Demographics
NPI:1679243158
Name:MERCY BEHAVIORAL HEALTH CENTER, INC
Entity Type:Organization
Organization Name:MERCY BEHAVIORAL HEALTH CENTER, INC
Other - Org Name:MERCY BEHAVIORAL HEALTH CENTER, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ISIAKA
Authorized Official - Middle Name:BAYOWA
Authorized Official - Last Name:IBRAHEEM
Authorized Official - Suffix:
Authorized Official - Credentials:MSC
Authorized Official - Phone:443-535-3485
Mailing Address - Street 1:5438 YORK RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-3837
Mailing Address - Country:US
Mailing Address - Phone:410-323-2300
Mailing Address - Fax:443-219-6640
Practice Address - Street 1:5438 YORK RD STE 101
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-3837
Practice Address - Country:US
Practice Address - Phone:410-323-2300
Practice Address - Fax:443-219-6640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-16
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder