Organization
LONG INTEGRATED PSYCHIATRIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA DESIREE LONG (OWNER)
(410) 508-0722
Entity
Organization
Contact information
Practice address
2225 OLD EMMORTON RD STE 210, BEL AIR, MD 21015-6123
(410) 508-0722
(410) 834-1851
Mailing address
11560 CROSSROADS CIR STE 102, MIDDLE RIVER, MD 21220-2885
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/05/2024
Last updated
09/05/2024
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