# FORMATIONS HEALTH

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

## Provider details

- **NPI number:** 1922852862
- **Authorized official:** MRS. TEKESHA M TYSON (CEO OF FORMATIONS HEALTH)
- **Authorized official phone:** (443) 846-9239

## Contact information

- **Practice address:** 710 N HAMMONDS FERRY RD, LINTHICUM HEIGHTS, MD 21090-1313
- **Practice address phone:** (410) 636-7057
- **Mailing address:** 710 N HAMMONDS FERRY RD, LINTHICUM HEIGHTS, MD 21090-1313
- **Mailing address phone:** (410) 636-7057

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 04/16/2024
- **Last updated:** 04/16/2024