Provider Demographics
NPI:1770392904
Name:HALYARD BEHAVIORAL HEALTH & WELLNESS, PLLC
Entity type:Organization
Organization Name:HALYARD BEHAVIORAL HEALTH & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TASHICA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:HALYARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-508-3604
Mailing Address - Street 1:2415 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-5017
Mailing Address - Country:US
Mailing Address - Phone:240-718-8274
Mailing Address - Fax:410-810-2176
Practice Address - Street 1:1733 N BENTALOU ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-3704
Practice Address - Country:US
Practice Address - Phone:240-718-8274
Practice Address - Fax:410-810-2176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness