Organization
ADVANCED BEHAVIORAL HEALTH SOLUTIONS - LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUNNY B DIFFANG MSN, PMHNP-BC (OWNER OF ENTITY)
(410) 528-3866
Entity
Organization
Contact information
Practice address
1410 CRAIN HWY N STE 2B, GLEN BURNIE, MD 21061-9304
(443) 870-1037
Mailing address
3523 CORN STREAM RD, RANDALLSTOWN, MD 21133-2442
(410) 528-3866
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
07/15/2021
Last updated
12/04/2024
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