Organization
STAYWELL BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAM WATFORD MANAGER (CREDENTIALING)
(410) 569-4165
Entity
Organization
Contact information
Practice address
10451 MILL RUN CIR STE 400, OWINGS MILLS, MD 21117-5594
(443) 525-1495
Mailing address
PO BOX 28, ABINGDON, MD 21009-0028
(410) 569-4165
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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