Organization
ELLICOTT CITY MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANANDRAJ MATTAI (OWNER)
(443) 542-0773
Entity
Organization
Contact information
Practice address
9256 BENDIX RD STE 200B, COLUMBIA, MD 21045-1848
(443) 542-0773
Mailing address
9256 BENDIX RD STE 200B, COLUMBIA, MD 21045-1848
(443) 542-0773
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
02/25/2019
Last updated
06/11/2019
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