Provider Demographics
NPI:1841015021
Name:PROTOCOL, LLC
Entity type:Organization
Organization Name:PROTOCOL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:DEVANTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:TEEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-515-9157
Mailing Address - Street 1:1301 YORK RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6035
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 N MONROE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-1316
Practice Address - Country:US
Practice Address - Phone:443-760-2264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Yes251S00000XAgenciesCommunity/Behavioral Health