NPIMap

Organization Active NPI

Maryland Health Foundation LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dundalk, MD
National Provider Identifier
1417783358
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MARYLAND HEALTH FOUNDATION LLC
Practice address
6910 Holabird Ave Ste a
Dundalk, MD 21222-1788
Phone
(443) 761-9169
NPI assigned
Sep 9, 2024
Last updated
Jul 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Authorized official

Name
Mustafa Abdulrahman
Title
Ceo
Phone
(443) 761-9169

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Adult Mental Health Clinic/Center 261QM0850X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU

Addresses

Primary practice location

6910 Holabird Ave Ste a
Dundalk, MD 21222-1788

Mailing address

6910 Holabird Ave Ste a
Dundalk, MD 21222-1788
Phone (443) 761-9169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251226000025 MD Part B Supplier - Clinic/Group Practice 4587150776 Receives reassigned benefits from 2 practitioners
Practice locations: Dundalk, MD

National Provider Directory

National Provider Directory
Tax ID family
Maryland Health Foundation LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1725840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751414400000",
    "number": "1417783358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 HOLABIRD AVE STE A",
            "city": "DUNDALK",
            "state": "MD",
            "postal_code": "212221788",
            "telephone_number": "443-761-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 HOLABIRD AVE STE A",
            "city": "DUNDALK",
            "state": "MD",
            "postal_code": "212221788",
            "telephone_number": "443-761-9169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND HEALTH FOUNDATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-09",
        "last_updated": "2025-07-02",
        "certification_date": "2025-06-12",
        "status": "A",
        "authorized_official_last_name": "ABDULRAHMAN",
        "authorized_official_first_name": "MUSTAFA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-761-9169"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dundalk, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.