NPIMap

Organization Active NPI

Citywide Behavioral Health

  • Mental Illness Community Based Residential Treatment Facility
  • Baltimore, MD
National Provider Identifier
1790519031
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
CITYWIDE BEHAVIORAL HEALTH
Practice address
3413 Powhatan Ave
Baltimore, MD 21216-1379
Phone
(410) 484-0036
NPI assigned
Aug 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Authorized official

Name
Pamela Penina Johnson, CRNPNPI 1023252129
Title
Ceo
Phone
(410) 484-0036

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

3413 Powhatan Ave
Baltimore, MD 21216-1379

Mailing address

17 Warren Rd Ste 20B
Pikesville, MD 21208-5334
Phone (410) 484-0036

National Provider Directory

National Provider Directory
Tax ID family
Citywide Behavioral Health11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1790519031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 WARREN RD STE 20B",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212085334",
            "telephone_number": "410-484-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3413 POWHATAN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212161379",
            "telephone_number": "410-484-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITYWIDE BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "PENINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-484-0036",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 29, 2024; 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.