Organization
COMMUNITY BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACY GILBERT (CREDENTIAL MANAGER)
(844) 224-5264
Entity
Organization
Contact information
Practice address
10774 HICKORY RIDGE RD, COLUMBIA, MD 21044-3646
(844) 224-5264
Mailing address
426 DORCHESTER AVE, CAMBRIDGE, MD 21613-2446
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
422612708
—
MD
Enumeration date
12/15/2020
Last updated
12/15/2020
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