NPIMap

Organization Active NPI

MMBR Behavioral Health Services Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
National Provider Identifier
1063091965
Registry record updated May 20, 2021
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
MMBR BEHAVIORAL HEALTH SERVICES INC.
Practice address
3804 S Hanover St
Baltimore, MD 21225
Phone
(301) 655-5086
Fax
(443) 438-3479
NPI assigned
Apr 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Authorized official

Name
Ms. Bolakunmi Yusuf
Title
Ceo/Owner
Phone
(301) 655-5086

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

3804 S Hanover St
Baltimore, MD 21225

Mailing address

3804 S Hanover St
Baltimore, MD 21225
Phone (301) 655-5086

Other practice location 1

3804 s.hanover st
brooklyn, MD 21225
Phone (443) 438-3457

Other names 2

  • MMBR BEHAVIORAL HEALTH SERVICES INC Doing business as
  • MMBR INC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
MMBR Behavioral Health Services Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1617753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1063091965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3804 S HANOVER ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21225",
            "telephone_number": "301-655-5086",
            "fax_number": "443-438-3479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 S HANOVER ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21225",
            "telephone_number": "301-655-5086",
            "fax_number": "443-438-3479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3804 s.hanover st",
            "address_purpose": "LOCATION",
            "city": "brooklyn",
            "state": "MD",
            "postal_code": "21225",
            "country_code": "US",
            "telephone_number": "443-438-3457",
            "fax_number": "443-438-3479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MMBR BEHAVIORAL HEALTH SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "YUSUF",
        "authorized_official_first_name": "BOLAKUNMI",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "301-655-5086",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMBR BEHAVIORAL HEALTH SERVICES INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MMBR BEHAVIORAL HEALTH SERVICES INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MMBR INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 May 20, 2021; 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.