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Organization

PROACTIVE BEHAVIORAL HEALTH SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GARRY ALLEN SMITH JR. (PROGRAM DIRECTOR/OWNER)
(443) 678-8556
Entity
Organization

Contact information

Practice address
1045 TAYLOR AVE, SUITE 216, BALTIMORE, MD 21286-8331
(443) 678-8556
Mailing address
1045 TAYLOR AVE, SUITE 216, BALTIMORE, MD 21286-8317
(443) 678-8556

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
251S00000X
MD

Other

Enumeration date
10/25/2016
Last updated
04/27/2017
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