Provider Demographics
NPI:1689371353
Name:EXODUS BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:EXODUS BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EXODUS
Authorized Official - Last Name:APELSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:175-933-3336
Mailing Address - Street 1:700 WASHINGTON BOULEVARD
Mailing Address - Street 2:EXODUS ATTN: JAMES APELSTEIN
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230
Mailing Address - Country:US
Mailing Address - Phone:617-593-3333
Mailing Address - Fax:
Practice Address - Street 1:115 E MELROSE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-2945
Practice Address - Country:US
Practice Address - Phone:410-343-4343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD00000Medicaid