NPIMap

Organization Active NPI

Magnolia Behavior Health Center LLC

  • Early Intervention Provider Agency
  • Frederick, MD
National Provider Identifier
1275317935
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
MAGNOLIA BEHAVIOR HEALTH CENTER LLC
Practice address
604 Solarex CT Unit 205
Frederick, MD 21703-8655
Phone
(240) 919-6062
Fax
(301) 698-8789
NPI assigned
Aug 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Authorized official

Name
Julia ShirimaNPI 1154148351
Title
Owner
Phone
(240) 919-6062

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

604 Solarex CT Unit 205
Frederick, MD 21703-8655

Mailing address

604 Solarex CT Unit 205
Frederick, MD 21703-8655
Phone (240) 919-6062

National Provider Directory

National Provider Directory
Tax ID family
Magnolia Behavior Health Center LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698278400000",
    "number": "1275317935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 SOLAREX CT UNIT 205",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038655",
            "telephone_number": "240-919-6062",
            "fax_number": "301-698-8789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 SOLAREX CT UNIT 205",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038655",
            "telephone_number": "240-919-6062",
            "fax_number": "301-698-8789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA BEHAVIOR HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A",
        "authorized_official_last_name": "SHIRIMA",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-919-6062"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.