Organization
COMMUNITY BASED SEVICES PRP AT EQUANIMITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TAVIN PARKER (MEMBER)
(404) 980-4808
Entity
Organization
Contact information
Practice address
10665 STANHAVEN PL, WHITE PLAINS, MD 20695-3055
(404) 980-4808
(240) 241-6360
Mailing address
10665 STANHAVEN PL, WHITE PLAINS, MD 20695-3055
(404) 980-4808
(240) 241-6360
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/29/2026
Last updated
07/29/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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