Provider Demographics
NPI:1790451482
Name:HIGHTOWER BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:HIGHTOWER BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNLOWO-OMOBHUDE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:410-595-6199
Mailing Address - Street 1:420 CRAIN HWY S STE 3
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3657
Mailing Address - Country:US
Mailing Address - Phone:410-595-6199
Mailing Address - Fax:410-684-5334
Practice Address - Street 1:420 CRAIN HWY S STE 3
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3657
Practice Address - Country:US
Practice Address - Phone:410-595-6199
Practice Address - Fax:410-684-5334
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIGHTOWER BEHAVIORAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-21
Last Update Date:2021-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health