Organization
TARGET BEHAVIORAL HEALTH SERVICES, LLC
Active
Other names
Target Behavioral Health Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FOLASHADE KANIMODO CRNP (CEO)
(410) 900-8897
Entity
Organization
Contact information
Practice address
15 E CHURCHVILLE RD STE 106, BEL AIR, MD 21014-3837
(410) 888-7143
(410) 888-7145
Mailing address
1415 MOONSHADOW RD, BEL AIR, MD 21015-4999
(410) 900-8897
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/07/2020
Last updated
07/09/2025
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