Bon Secours

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BON SECOURS

Practice address

3101 Towanda Ave
Baltimore, MD 21215-7827

Phone

(410) 383-5100

NPI assigned

Dec 31, 2009

Organization subpart

Yes

Parent organization

BON SECOUR BALTIMORE HEALTH SYSTEMAs reported in NPPES

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

Authorized official

Name

Mr. Adam Gomez, LCSW-C

Title

Clinical Director

Phone

(410) 383-5100

Specialties & licenses 1

Addresses

Part of

Libert Medical Center C

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

{
    "created_epoch": "1262217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262217600000",
    "number": "1184954836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 TOWANDA AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212157827",
            "telephone_number": "410-383-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 TOWANDA AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212157827",
            "telephone_number": "410-383-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BON SECOUR BALTIMORE HEALTH SYSTEM",
        "enumeration_date": "2009-12-31",
        "last_updated": "2009-12-31",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "410-383-5100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bolton Therapy & Wellness
• Bolum Logistics LLC
• Emily Bomasang-Layno, M.D.
• Michael Bombardier, PHD
• Deepthi K Bommadevara, M.D; M.P.H
• Bon Secours Baltimore Physician Group LLC
• Bon Secours Hospital-Mobile MRI
• Julia T Bonacum, MD
• Hugo Bonatti, MD
• Stephanie Lynn Boncich, MSN, CRNA

• Community/Behavioral Health Agency in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2009; 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.