Provider Demographics
NPI:1144723313
Name:MARYLAND BEHAVIORAL HEALTH CARE LLC
Entity type:Organization
Organization Name:MARYLAND BEHAVIORAL HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAGAN MOHAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:ARRAMRAJU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-759-7597
Mailing Address - Street 1:5900 YORK RD STE 201
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-3097
Mailing Address - Country:US
Mailing Address - Phone:410-949-9755
Mailing Address - Fax:443-868-5380
Practice Address - Street 1:5900 YORK RD STE 201
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-3097
Practice Address - Country:US
Practice Address - Phone:410-949-9755
Practice Address - Fax:443-868-5380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health