NPIMap

Organization Active NPI

Jr Healthcare Associates, LLC

  • Adult Mental Health Clinic/Center
  • Baltimore, MD
National Provider Identifier
1124471651
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
MH-1846 Issued in MD
Legal business name
JR HEALTHCARE ASSOCIATES, LLC
Doing business as
Behavioral Health Clinic (BHC)
Practice address
2310 N Charles St
Baltimore, MD 21218-5127
Phone
(410) 844-4110
Fax
(410) 741-3008
NPI assigned
Jul 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Authorized official

Name
Nag Nelluri
Title
Member
Phone
(443) 995-4113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X MH-1846 MD Primary

Addresses

Primary practice location

2310 N Charles St
Baltimore, MD 21218-5127

Mailing address

2310 N Charles St
Baltimore, MD 21218-5127
Phone (410) 844-4110

Other identifiers 2

IdentifierTypeStateIssuer
4239041-00MedicaidMD
4233417-00MedicaidMD

Other names 1

  • Behavioral Health Clinic (BHC) Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Behavioral Health Clinic BHC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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": "1468972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468972800000",
    "number": "1124471651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185127",
            "telephone_number": "410-844-4110",
            "fax_number": "410-741-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185127",
            "telephone_number": "410-844-4110",
            "fax_number": "410-741-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JR HEALTHCARE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-07-20",
        "status": "A",
        "authorized_official_last_name": "NELLURI",
        "authorized_official_first_name": "NAG",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "443-995-4113"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MD",
            "license": "MH-1846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4239041-00",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4233417-00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Behavioral Health Clinic (BHC)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 20, 2016; 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.