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Organization
TAS BEHAVIORAL HEALTH
Active
Organization
TAS BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA NKONGCHU (OWNER OF ENTITY)
(240) 599-5177
Entity
Organization
Contact information
Practice address
33 W FRANKLIN ST STE 201, HAGERSTOWN, MD 21740-4863
(240) 599-5177
Mailing address
4300 CEDAR REACH LN, BOWIE, MD 20720-5808
(240) 599-5177
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/16/2023
Last updated
12/27/2024
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