Organization
CHASE BREXTON HEALTH SERVICES, INC.
Active
Other names
Chase Brexton Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KYLE EASTON (REVENUE CYCLE DIRECTOR)
(410) 837-2050
Entity
Organization
Contact information
Practice address
5500 KNOLL NORTH DR, STE 370, COLUMBIA, MD 21045-2209
(410) 884-7831
(410) 715-3734
Mailing address
1111 NORTH CHARLES STREET, BALTIMORE, MD 21201
(410) 837-2050
(410) 752-1374
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132190100
—
MD
Enumeration date
06/20/2006
Last updated
04/15/2024
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