Avaya Health Services of Maryland, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

AVAYA HEALTH SERVICES OF MARYLAND, LLC

Practice address

1812 Guilford Ave
Baltimore, MD 21202-2833

Phone

(919) 454-1672

NPI assigned

May 2, 2017

Organization subpart

No

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

Authorized official

Name

Dwayne Gray

Title

President

Phone

(919) 454-1672

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493683200000",
    "number": "1740716422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 HECKLE BLVD",
            "address_2": "STE. 103-262",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297324803",
            "telephone_number": "919-454-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 GUILFORD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022833",
            "telephone_number": "919-454-1672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVAYA HEALTH SERVICES OF MARYLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-02",
        "last_updated": "2017-05-02",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "DWAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-454-1672"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; 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.