Fa Medical LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

FA MEDICAL LLC

Practice address

925 Brooks LN
Baltimore, MD 21217-4512

Phone

(888) 888-8888

NPI assigned

Jun 30, 2025

Organization subpart

No

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

Authorized official

Name

Desiree Mountain

Title

Compliance Officer

Phone

(443) 204-5800

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1751241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751241600000",
    "number": "1700775392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 BANCROFT RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212153105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 BROOKS LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212174512",
            "telephone_number": "888-888-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FA MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A",
        "authorized_official_last_name": "MOUNTAIN",
        "authorized_official_first_name": "DESIREE",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "443-204-5800"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camellus O Ezeugwu, M.D.
• Ngozi Ezike, MD
• Moshe Ezra
• Yisrael Ezra
• F Kamara Medical, P.C.
• Matteo Fabbri, MD, MS
• William Paul Fabbri, M.D.
• Erik Faber, MD, PHD
• Craig Howard Fabian, RN
• Elizabeth Ashton Fabian, PA

• Substance Use Disorder Rehabilitation Clinic/Center in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.