# STAYWELL BEHAVIORAL HEALTH, LLC

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

## Provider details

- **NPI number:** 1396392452
- **Authorized official:** PAM WATFORD MANAGER (CREDENTIALING)
- **Authorized official phone:** (410) 569-4165

## Contact information

- **Practice address:** 10451 MILL RUN CIR STE 400, OWINGS MILLS, MD 21117-5594
- **Practice address phone:** (443) 525-1495
- **Mailing address:** PO BOX 28, ABINGDON, MD 21009-0028
- **Mailing address phone:** (410) 569-4165

## 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:** 08/23/2019
- **Last updated:** 08/23/2019