NPIMap

Organization Active NPI

Pitoc-Behavioral Health Systems, LLC

  • Children's Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1285042283
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
License
LCA369 Issued in MD
Legal business name
PITOC-BEHAVIORAL HEALTH SYSTEMS, LLC
Doing business as
PITOC-Behavioral Health Systems, LLC
Practice address
16 W 25TH St
Baltimore, MD 21218-5002
Phone
(443) 682-5807
NPI assigned
Jul 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Authorized official

Name
Omoruyi Ephraim K Okundaye, MSW, LCSW-C, LCADCNPI 1871900845
Title
Pincipal Investigator-Ceo
Phone
(443) 682-5807

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 17618 MD
Children's Substance Abuse Rehabilitation Facility 3245S0500X LCA369 MD Primary

Addresses

Primary practice location

16 W 25TH St
Baltimore, MD 21218-5002

Mailing address

PO Box 7921
Essex, MD 21221-0921
Phone (443) 682-5807

Other names 1

  • PITOC-Behavioral Health Systems, LLC Doing business as

National Provider Directory

National Provider Directory

Locations

16 W 25th St
Baltimore, MD 21218
Phone (443) 682-5807

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406073600000",
    "number": "1285042283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7921",
            "city": "ESSEX",
            "state": "MD",
            "postal_code": "212210921",
            "telephone_number": "443-682-5807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 W 25TH ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185002",
            "telephone_number": "443-682-5807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PITOC-BEHAVIORAL HEALTH SYSTEMS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-23",
        "last_updated": "2014-07-23",
        "status": "A",
        "authorized_official_last_name": "OKUNDAYE",
        "authorized_official_first_name": "OMORUYI",
        "authorized_official_middle_name": "EPHRAIM K",
        "authorized_official_title_or_position": "PINCIPAL INVESTIGATOR-CEO",
        "authorized_official_telephone_number": "443-682-5807",
        "authorized_official_credential": "MSW, LCSW-C, LCADC"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "MD",
            "license": "17618",
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "MD",
            "license": "LCA369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PITOC-Behavioral Health Systems, LLC",
            "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 23, 2014; 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.