# ERTA BEHAVIORAL HEALTH, LLC

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

## Provider details

- **NPI number:** 1487284816
- **Authorized official:** JON KOGAN (DELEGATED OFFICIAL)
- **Authorized official phone:** (443) 253-5533

## Contact information

- **Practice address:** 7400 WILHELM DR, LANHAM, MD 20706-3725
- **Practice address phone:** (240) 501-2710
- **Mailing address:** 7400 WILHELM DR, LANHAM, MD 20706-3725
- **Mailing address phone:** (240) 501-2710

## 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:** 01/24/2020
- **Last updated:** 06/17/2020