Push Behavioral Health, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PUSH BEHAVIORAL HEALTH, LLC

Practice address

9 Center PL
Dundalk, MD 21222-4362

Phone

(410) 417-6868

NPI assigned

Sep 21, 2018

Last updated

Sep 21, 2018By 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

Kenneth Collins

Title

Owner

Phone

(410) 417-6868

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537488000000",
    "number": "1659855955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 LAKESIDE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183005",
            "telephone_number": "443-690-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CENTER PL",
            "city": "DUNDALK",
            "state": "MD",
            "postal_code": "212224362",
            "telephone_number": "410-417-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUSH BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-21",
        "last_updated": "2018-09-21",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-417-6868"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; 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.