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Organization
BLUEGRASS MENTAL HEALTH
Active
Organization
BLUEGRASS MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITCHELL VINCENT MATHIS JR. M.D. (PARTNER)
(240) 678-6118
Entity
Organization
Contact information
Practice address
5840 BANNEKER RD, SUITE 200, COLUMBIA, MD 21044
(410) 630-7007
Mailing address
5840 BANNEKER RD STE 200, COLUMBIA, MD 21044-3156
(410) 457-3196
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/04/2015
Last updated
06/29/2018
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