NPIMap

Organization Active NPI

Kingdom Behavioral Health Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hagerstown, MD
National Provider Identifier
1003690454
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
KINGDOM BEHAVIORAL HEALTH SERVICES, LLC
Doing business as
Kingdom Behavioral Health Services, LLC
Practice address
5 Public SQ Ste 200
Hagerstown, MD 21740-5599
Phone
(301) 393-5500
NPI assigned
Aug 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Taofeek Bello, PMHNP-CRNP BC
Title
Chairman
Phone
(301) 393-5500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

5 Public SQ Ste 200
Hagerstown, MD 21740-5599

Mailing address

5 Public SQ Ste 200
Hagerstown, MD 21740-5599
Phone (301) 393-5500

Other names 1

  • Kingdom Behavioral Health Services, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kingdom Behavioral Health Services LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692835200000",
    "number": "1003690454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PUBLIC SQ STE 200",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405599",
            "telephone_number": "301-393-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PUBLIC SQ STE 200",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405599",
            "telephone_number": "301-393-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGDOM BEHAVIORAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "BELLO",
        "authorized_official_first_name": "TAOFEEK",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "301-393-5500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PMHNP-CRNP BC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kingdom Behavioral Health Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.