Provider Demographics
NPI:1710565544
Name:KH BEHAVIORAL HEALTH CENTER
Entity Type:Organization
Organization Name:KH BEHAVIORAL HEALTH CENTER
Other - Org Name:KH BEHAVIORAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:HARVELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-255-0122
Mailing Address - Street 1:3435 GREENMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-2941
Mailing Address - Country:US
Mailing Address - Phone:443-255-0122
Mailing Address - Fax:667-303-3152
Practice Address - Street 1:3435 GREENMOUNT AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2942
Practice Address - Country:US
Practice Address - Phone:443-255-0122
Practice Address - Fax:667-303-3152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-01
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health