NPIMap

Organization Active NPI

Main Street Mobile Treatment Associates

  • Community/Behavioral Health Agency
  • Reisterstown, MD
National Provider Identifier
1154511236
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MAIN STREET MOBILE TREATMENT ASSOCIATES
Doing business as
Main Street Community Mental Health Center
Practice address
37 Main St
Reisterstown, MD 21136-1236
Phone
(410) 526-7882
Fax
(410) 526-9855
NPI assigned
Jul 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Authorized official

Name
Mrs. Pamala Ryan, RN
Title
Executive Director
Phone
(410) 654-6658

Specialties & licenses 1

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

Addresses

Primary practice location

37 Main St
Reisterstown, MD 21136-1236

Mailing address

37 Main St
Reisterstown, MD 21136-1236
Phone (410) 526-7882

Other identifiers 1

IdentifierTypeStateIssuer
749002000MedicaidMD

Other names 1

  • Main Street Community Mental Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Main Street Community Mental Health Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

37 Main St
Reisterstown, MD 21136
Phone (410) 526-7882

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551312000000",
    "number": "1154511236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 MAIN ST",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361236",
            "telephone_number": "410-526-7882",
            "fax_number": "410-526-9855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 MAIN ST",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361236",
            "telephone_number": "410-526-7882",
            "fax_number": "410-526-9855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET MOBILE TREATMENT ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2019-02-28",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "PAMALA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-654-6658",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "749002000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Street Community Mental Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Main Street Community Mental Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reisterstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.