Coreridge Health Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

CORERIDGE HEALTH INC

Practice address

843 Crystal Palace CT
Owings Mills, MD 21117-2257

Phone

(443) 538-3964

NPI assigned

Nov 7, 2024

Organization subpart

No

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

Authorized official

Name

Gbemisola Tegbe

Title

Executive Director

Phone

(443) 538-3964

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1841013877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10807 FALLS RD UNIT 255",
            "city": "BROOKLANDVILLE",
            "state": "MD",
            "postal_code": "210227511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "843 CRYSTAL PALACE CT",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211172257",
            "telephone_number": "443-538-3964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORERIDGE HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "TEGBE",
        "authorized_official_first_name": "GBEMISOLA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "443-538-3964"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott B Coon, PT MTC CFMT
• Elisabeth Brenda Cooper
• Helene Frances Cooper, LCSW-C
• Mariah Copeland-Dixon
• Jordan Copeland, CRNP
• Caitlin Cork, LCSW-C
• Cornelia Israel, LCPC, LLC
• Daniel Corning, MD
• Jennifer Cornish
• Cosmetic Smile and Denture Technology Consultants LLC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.