Provider Demographics
NPI:1760853212
Name:HARWOOD BEHAVIORAL HEALTH PARTNERS, LLC
Entity Type:Organization
Organization Name:HARWOOD BEHAVIORAL HEALTH PARTNERS, LLC
Other - Org Name:CCG BALTIMORE
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS OPERATIONS DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WAHL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MA
Authorized Official - Phone:667-239-3205
Mailing Address - Street 1:428 E 25TH ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-5304
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:428 E 25TH ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-5304
Practice Address - Country:US
Practice Address - Phone:410-617-0142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONCERTED CARE GROUP HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-09
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory