NPIMap

Organization Active NPI

Big Gibby's Haven LLC

  • Community/Behavioral Health Agency
  • Baltimore, MD
National Provider Identifier
1083419592
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
BIG GIBBY'S HAVEN LLC
Practice address
1 E Chase St # R3J-a
Baltimore, MD 21202-2526
Phone
(443) 762-4929
NPI assigned
Feb 18, 2025
Last updated
Feb 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Authorized official

Name
Daries Gibson
Title
Ceo
Phone
(443) 762-4929

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

1 E Chase St # R3J-a
Baltimore, MD 21202-2526

Mailing address

9661 Davison Rd
Baltimore, MD 21220-3887

National Provider Directory

National Provider Directory
Tax ID family
Big Gibby's Haven 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": "1739836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739836800000",
    "number": "1083419592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9661 DAVISON RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212203887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E CHASE ST # R3J-A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022526",
            "telephone_number": "443-762-4929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG GIBBY'S HAVEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-18",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "DARIES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-762-4929"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "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 Feb 18, 2025; 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.