Provider Demographics
NPI:1639560717
Name:FIRST CHOICE BEHAVIORAL HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:FIRST CHOICE BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SURIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-929-4793
Mailing Address - Street 1:9199 REISTERSTOWN RD STE 105B
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4513
Mailing Address - Country:US
Mailing Address - Phone:410-929-4793
Mailing Address - Fax:410-779-9400
Practice Address - Street 1:17 WARREN RD STE 1-A&B
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208
Practice Address - Country:US
Practice Address - Phone:410-929-4793
Practice Address - Fax:410-779-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health