Organization
GEMINI HEALTH HOLDINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUDHIR RAO AUTHORIZED SIGNATORY (OWNER/PHYSICIAN)
(443) 701-9295
Entity
Organization
Contact information
Practice address
6816 DEERPATH RD, ELKRIDGE, MD 21075-6200
(301) 703-8767
(301) 703-8886
Mailing address
2702 BACK ACRE CIR STE 290B, MOUNT AIRY, MD 21771-7769
(443) 701-9295
(301) 703-8886
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
103TR0400X
Rehabilitation Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
174400000X
Specialist
—
—
2084P0800X
Psychiatry Physician
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
01/24/2020
Last updated
07/24/2020
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