Organization
COMMUNITY BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACY GILBERT (CREDENTIALING MANAGER)
(844) 224-5264
Entity
Organization
Contact information
Practice address
1140 BLADES FARM RD STE 202, DENTON, MD 21629-3489
(844) 224-5264
Mailing address
426 DORCHESTER AVE, CAMBRIDGE, MD 21613-2446
(844) 224-5264
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
422612701
—
MD
Enumeration date
09/02/2022
Last updated
09/02/2022
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