Provider Demographics
NPI:1255442323
Name:BEHAVIORAL HEALTH AND SUBSTANCE ABUSE NETWORK, INC.
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH AND SUBSTANCE ABUSE NETWORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:WILLSON
Authorized Official - Last Name:SWAIN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, ICADC,CADC II
Authorized Official - Phone:301-613-2750
Mailing Address - Street 1:9639 OXBRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721
Mailing Address - Country:US
Mailing Address - Phone:301-613-2750
Mailing Address - Fax:301-386-3521
Practice Address - Street 1:600 W ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1241
Practice Address - Country:US
Practice Address - Phone:301-613-2750
Practice Address - Fax:301-386-3521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500780811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty