NPIMap

Organization Active NPI

Agate Integrated and Behavioral Healthcare Services

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Baltimore, MD
National Provider Identifier
1780323733
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
Legal business name
AGATE INTEGRATED AND BEHAVIORAL HEALTHCARE SERVICES
Practice address
2323 Maryland Avenue
Suite 1a
Baltimore, MD 21218
Phone
(443) 934-0084
NPI assigned
May 28, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Authorized official

Name
Mr. Jimoh Adepoju Adebayo
Title
Ceo
Phone
(240) 515-4868

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X Primary

Addresses

Primary practice location

2323 Maryland Avenue
Suite 1a
Baltimore, MD 21218

Mailing address

2323 Maryland Avenue
Suite 1a
Baltimore, MD 21218
Phone (443) 934-0084

Other identifiers 3

IdentifierTypeStateIssuer
1609470327MedicaidMD
1629653894MedicaidMD
1871245811MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Agate Integrated and Behavioral Healthcare Services Inc17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1653696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656633600000",
    "number": "1780323733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 MARYLAND AVENUE",
            "address_2": "SUITE 1A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21218",
            "telephone_number": "443-934-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 MARYLAND AVENUE",
            "address_2": "SUITE 1A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21218",
            "telephone_number": "443-934-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGATE INTEGRATED AND BEHAVIORAL HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-28",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A",
        "authorized_official_last_name": "ADEBAYO",
        "authorized_official_first_name": "JIMOH",
        "authorized_official_middle_name": "ADEPOJU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-515-4868",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609470327",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629653894",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871245811",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "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 Jul 1, 2022; 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.