# ESHCOL BEHAVIORAL SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Eshcol Behavioral Services llc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053073940
- **Authorized official:** AKHERE GWAN NP (PSYCHIATRIC NURSE PRACTITIONER)
- **Authorized official phone:** (617) 461-3856

## Contact information

- **Practice address:** 6223 SWEET GUM LN, HANOVER, MD 21076-2127
- **Practice address phone:** (617) 461-3856
- **Mailing address:** 6223 SWEET GUM LN, HANOVER, MD 21076-2127

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/08/2021
- **Last updated:** 11/03/2021