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Organization
BEHAVIORAL HEALTH AFFILIATES LLC
Active
Organization
BEHAVIORAL HEALTH AFFILIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONY CROSS CRNP-PMH (OWNER)
(919) 408-4627
Entity
Organization
Contact information
Practice address
2670 CRAIN HWY STE 510, WALDORF, MD 20601-2819
(301) 374-8772
(301) 374-8774
Mailing address
2107 TURLEYGREEN PL, UPPER MARLBORO, MD 20774-8984
(919) 408-4627
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/30/2021
Last updated
09/30/2021
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