Provider Demographics
NPI:1912897745
Name:TEAM K BEHAVIORAL HEALTHCARE SERVICES, LLC
Entity type:Organization
Organization Name:TEAM K BEHAVIORAL HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARIAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOUROUMA
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:804-651-3368
Mailing Address - Street 1:8338 WAGON WHEEL RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-2154
Mailing Address - Country:US
Mailing Address - Phone:804-651-3368
Mailing Address - Fax:
Practice Address - Street 1:6808 EASTERN AVE STE 2
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-3001
Practice Address - Country:US
Practice Address - Phone:443-839-7448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEAM K BEHAVIORAL HEALTHCARE SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health