# TARGET BEHAVIORAL HEALTH SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Target Behavioral Health Services, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235749771
- **Authorized official:** DR. FOLASHADE KANIMODO CRNP (CEO)
- **Authorized official phone:** (410) 900-8897

## Contact information

- **Practice address:** 15 E CHURCHVILLE RD STE 106, BEL AIR, MD 21014-3837
- **Practice address phone:** (410) 888-7143
- **Practice address fax:** (410) 888-7145
- **Mailing address:** 1415 MOONSHADOW RD, BEL AIR, MD 21015-4999
- **Mailing address phone:** (410) 900-8897

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/07/2020
- **Last updated:** 07/09/2025