NPIMap

Organization Active NPI

Kingdom Behavioral Health Services, LLC

  • Substance Abuse Rehabilitation Facility
  • Hagerstown, MD
National Provider Identifier
1073398855
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
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
Fax
(301) 393-5600
NPI assigned
Aug 29, 2023
Last updated
Aug 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Authorized official

Name
Taofeek Bello
Title
Chairman
Phone
(301) 393-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X NU Primary

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": "1693267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693267200000",
    "number": "1073398855",
    "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",
            "fax_number": "301-393-5600"
        },
        {
            "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",
            "fax_number": "301-393-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGDOM BEHAVIORAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-28",
        "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"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "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 29, 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.