NPIMap

Organization Active NPI

Issaiah House Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Baltimore, MD
National Provider Identifier
1518563022
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
ISSAIAH HOUSE INC
Practice address
919 Calwell Rd
Baltimore, MD 21229-5006
Phone
(443) 882-1943
Fax
(410) 558-6222
NPI assigned
Dec 9, 2020
Organization subpart
Yes
Parent organization
ISSAIAH HOUSE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Authorized official

Name
Mr. Darryl Braxton, LCPC
Title
Owner
Phone
(443) 882-1943

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

919 Calwell Rd
Baltimore, MD 21229-5006

Mailing address

919 Calwell Rd
Baltimore, MD 21229-5006
Phone (443) 882-1943

Other identifiers 1

IdentifierTypeStateIssuer
160026500MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Icanotes Direct

National Provider Directory

National Provider Directory
Tax ID family
Issaiah House Inc4 organizations share this tax ID, including this one
Part of
Issaiah House Inc

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1518563022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 CALWELL RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295006",
            "telephone_number": "443-882-1943",
            "fax_number": "410-558-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 CALWELL RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295006",
            "telephone_number": "443-882-1943",
            "fax_number": "410-558-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISSAIAH HOUSE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ISSAIAH HOUSE INC",
        "enumeration_date": "2020-12-09",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A",
        "authorized_official_last_name": "BRAXTON",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-882-1943",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160026500",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Icanotes",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "919 Calwell Rd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212295006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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 Jan 7, 2021; 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.