Grant House Behavioral Health LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

GRANT HOUSE BEHAVIORAL HEALTH LLC

Practice address

4920 Belair Rd Ste 2C&2D
Baltimore, MD 21206-5601

Phone

(410) 732-0236

Fax

(443) 449-5338

NPI assigned

Oct 12, 2017

Last updated

Jan 8, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Towanda Grant-Cunningham

Title

Executive Director

Phone

(717) 701-7732

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546905600000",
    "number": "1588175913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 BELAIR RD SUITE 2C & 2D",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212063724",
            "telephone_number": "410-732-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 BELAIR RD STE 2C&2D",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212065601",
            "telephone_number": "410-732-0236",
            "fax_number": "443-449-5338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2604 E Preston St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212133724",
            "country_code": "US",
            "telephone_number": "410-732-0236",
            "fax_number": "443-449-5338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRANT HOUSE BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-12",
        "last_updated": "2019-01-08",
        "status": "A",
        "authorized_official_last_name": "GRANT-CUNNINGHAM",
        "authorized_official_first_name": "TOWANDA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "717-701-7732"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500265600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Addiction (Substance Use Disorder) Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.