# LONG INTEGRATED PSYCHIATRIC SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LONG INTEGRATED PSYCHIATRIC SERVICES LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1295510113
- **Legal business name:** LONG INTEGRATED PSYCHIATRIC SERVICES LLC
- **Authorized official:** ERIKA HEAVNER (MANAGER)
- **Authorized official phone:** (410) 508-0722

## Contact information

- **Practice address:** 1101 N POINT BLVD STE 131, BALTIMORE, MD 21224-3417
- **Practice address phone:** (410) 508-0722
- **Practice address fax:** (410) 834-1851
- **Mailing address:** 11560 CROSSROADS CIR STE 102, MIDDLE RIVER, MD 21220-2885
- **Mailing address phone:** (410) 508-0722

## Taxonomy

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

## Other

- **Enumeration date:** 08/29/2023
- **Last updated:** 08/29/2023