NPIMap

Organization Active NPI

Pyramid Walden LLC

  • Community/Behavioral Health Agency
  • Charlotte Hall, MD
National Provider Identifier
1174869291
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MH-915 Issued in MD
Legal business name
PYRAMID WALDEN LLC
Practice address
30007 Business Center Dr
Charlotte Hall, MD 20622-3101
Phone
(301) 997-1300
Fax
(301) 290-0280
NPI assigned
Dec 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Authorized official

Name
Jason Hendricks
Title
Chief Executive Officer
Phone
(814) 940-0407

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MH-915 MD Primary

Addresses

Primary practice location

30007 Business Center Dr
Charlotte Hall, MD 20622-3101

Mailing address

30007 Business Center Dr
Charlotte Hall, MD 20622-3101
Phone (301) 997-1300

Other identifiers 1

IdentifierTypeStateIssuer
4214480-00MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Pyramid Walden LLC18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1174869291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30007 BUSINESS CENTER DR",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "206223101",
            "telephone_number": "301-997-1300",
            "fax_number": "301-290-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30007 BUSINESS CENTER DR",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "206223101",
            "telephone_number": "301-997-1300",
            "fax_number": "301-290-0280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PYRAMID WALDEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-18",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "814-940-0407"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "MH-915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4214480-00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte Hall, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.