# VINTAGE BEHAVIORAL HEALTHCARE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033909775
- **Authorized official:** ELIJAH JONES (CEO)
- **Authorized official phone:** (240) 388-9096

## Contact information

- **Practice address:** 4041 POWDER MILL RD STE 322B, BELTSVILLE, MD 20705-3106
- **Practice address phone:** (202) 843-3537
- **Mailing address:** 4041 POWDER MILL RD STE 322B, BELTSVILLE, MD 20705-3106
- **Mailing address phone:** (202) 843-3537

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | — | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | — | — | — |
| 324500000X | Substance Abuse Rehabilitation Facility | — | NULL | — |
| 3245S0500X | Children's Substance Abuse Rehabilitation Facility | — | NULL | — |

## Other

- **Enumeration date:** 05/07/2025
- **Last updated:** 08/11/2026