Organization
TARGET BEHAVIORAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FOLASHADE R KANIMODO PMHNP-BC (DIRECTOR)
(410) 888-7143
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) 888-7143
(410) 888-7145
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/14/2021
Last updated
01/26/2026
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