Organization
JR HEALTH CARE ASSOCIATES, LLC
Active
Other names
Behavioral Health Clininc (BHC)
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NAG NELLURI (PRESIDENT)
(443) 995-4113
Entity
Organization
Contact information
Practice address
2310 N CHARLES ST, BALTIMORE, MD 21218-5127
(410) 844-4110
(410) 741-3008
Mailing address
2310 N CHARLES ST, BALTIMORE, MD 21218-5127
(410) 844-4110
(410) 741-3008
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
MH-1962
MD
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
MH-1962
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053719575
NPI NUMBER (CD)
MD
01
—
1689042541
NPI NUMBER (MH)
MD
05
—
4233417-00
—
MD
05
—
4239041-00
—
MD
Enumeration date
05/05/2016
Last updated
05/05/2016
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