NPIMap

Organization Active NPI

Vintage Behavioral Healthcare Center LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Beltsville, MD
National Provider Identifier
1366368169
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
Legal business name
VINTAGE BEHAVIORAL HEALTHCARE CENTER LLC
Practice address
4041 Powder Mill Rd Ste 322B
Beltsville, MD 20705-3106
Phone
(240) 388-9096
NPI assigned
Jun 25, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Authorized official

Name
Elijah Jones, OWNER
Title
Owner
Phone
(202) 843-3537

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X Primary

Addresses

Primary practice location

4041 Powder Mill Rd Ste 322B
Beltsville, MD 20705-3106

Mailing address

10310 Swift Stream PL Apt 109
Columbia, MD 21044-4881

National Provider Directory

National Provider Directory
Tax ID family
Vintage Behavioral Healthcare Center LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

4041 Powder Mill Rd
Ste 322B
Beltsville, MD 20705

NPI Registry JSON

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

{
    "created_epoch": "1782345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782345600000",
    "number": "1366368169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10310 SWIFT STREAM PL APT 109",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210444881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 POWDER MILL RD STE 322B",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207053106",
            "telephone_number": "240-388-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINTAGE BEHAVIORAL HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-25",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ELIJAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-843-3537",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beltsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; 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.