Provider Demographics
NPI:1679348684
Name:HARWOOD BEHAVIORAL HEALTH II LLC
Entity Type:Organization
Organization Name:HARWOOD BEHAVIORAL HEALTH II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:667-239-3293
Mailing Address - Street 1:3905 NATIONAL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-6143
Mailing Address - Country:US
Mailing Address - Phone:667-239-3293
Mailing Address - Fax:
Practice Address - Street 1:10354 SUPERCENTER DR
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-9724
Practice Address - Country:US
Practice Address - Phone:667-239-3293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CCG HOLDCO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health