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Organization
INTEGRAHEALTH LLC
Active
Organization
INTEGRAHEALTH LLC
Active
Other names
Autumn Lake Healthcare Post Acute Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
KAMAL SALAH H SEWARALTHAHAB (CO-OWNER)
(410) 646-2100
Entity
Organization
Contact information
Practice address
5009 FRANKFORD AVE, BALTIMORE, MD 21206-5353
(410) 325-4000
Mailing address
9722 GROFFS MILL DR # 916, OWINGS MILLS, MD 21117-6341
(410) 870-9380
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/09/2025
Last updated
06/11/2025
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