# LONG INTEGRATED PSYCHIATRIC SERVICES LLC

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

## Provider details

- **NPI number:** 1891520078
- **Authorized official:** ANGELA DESIREE LONG (OWNER)
- **Authorized official phone:** (410) 508-0722

## Contact information

- **Practice address:** 2225 OLD EMMORTON RD STE 210, BEL AIR, MD 21015-6123
- **Practice address phone:** (410) 508-0722
- **Practice address fax:** (410) 834-1851
- **Mailing address:** 11560 CROSSROADS CIR STE 102, MIDDLE RIVER, MD 21220-2885

## 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:** 09/05/2024
- **Last updated:** 09/05/2024