NPIMap

Organization Active NPI

Familychoice Clinic LLC

  • Community/Behavioral Health Agency
  • Baltimore, MD
National Provider Identifier
1023698362
Registry record updated Dec 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FAMILYCHOICE CLINIC LLC
Practice address
5513 York Rd
Baltimore, MD 21212-3804
Phone
(443) 825-2955
Fax
(667) 212-2682
NPI assigned
Apr 12, 2021
Organization subpart
Yes
Parent organization
FAMILYCHOICE CLINIC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 30, 2023

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

Authorized official

Name
Margaret T T Owolabi
Title
Director
Phone
(443) 825-2955

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

5513 York Rd
Baltimore, MD 21212-3804

Mailing address

5513 York Rd
Baltimore, MD 21212-3804
Phone (667) 212-2682

Other practice location 1

13511 Label Ln Ste 3A
Hagerstown, MD 21740-2463
Phone (443) 825-2955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180125000608 MD Part B Supplier - Clinic/Group Practice 4486913191 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Baltimore, MD; Hagerstown, MD

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Familychoice Clinic LLC4 organizations share this tax ID, including this one
Part of
Familychoice Clinic LLC

Other organizations with this tax ID 3

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

Locations

5513 York Rd
Ste 2
Baltimore, MD 21212
Phone (443) 825-2955

13511 Label Ln
Ste 3A
Hagerstown, MD 21740
Phone (443) 825-2955

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703894400000",
    "number": "1023698362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5513 YORK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212123804",
            "telephone_number": "667-212-2682",
            "fax_number": "443-835-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5513 YORK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212123804",
            "telephone_number": "443-825-2955",
            "fax_number": "667-212-2682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13511 Label Ln Ste 3A",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217402463",
            "country_code": "US",
            "telephone_number": "443-825-2955",
            "fax_number": "212-667-2682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAMILYCHOICE CLINIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILYCHOICE CLINIC LLC",
        "enumeration_date": "2021-04-12",
        "last_updated": "2023-12-30",
        "certification_date": "2023-12-30",
        "status": "A",
        "authorized_official_last_name": "OWOLABI",
        "authorized_official_first_name": "MARGARET T",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-825-2955"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.