NPIMap

Organization Active NPI

Excellent Healthcare & Psychiatric Rehabilitation Program Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
National Provider Identifier
1942883699
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
EXCELLENT HEALTHCARE & PSYCHIATRIC REHABILITATION PROGRAM SERVICES INC
Practice address
4002 W Belvedere Ave Unit a
Baltimore, MD 21215-5502
Phone
(410) 984-7411
NPI assigned
Apr 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Authorized official

Name
Innocent Akpuaka
Title
The President
Phone
(410) 984-7411

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

4002 W Belvedere Ave Unit a
Baltimore, MD 21215-5502

Mailing address

4002 W Belvedere Ave Unit a
Baltimore, MD 21215-5502
Phone (410) 984-7411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210419001035 MD Part B Supplier - Clinic/Group Practice 6305254004 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Baltimore, MD

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Excellent Healthcare Psychiatric Rehabilitation Program Services Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

4002 W Belvedere Ave
#A
Baltimore, MD 21215
Phone (410) 984-7411

Practitioners & affiliated clinicians

Practitioners 4

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": "1619740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1942883699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 W BELVEDERE AVE UNIT A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155502",
            "telephone_number": "410-984-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 W BELVEDERE AVE UNIT A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155502",
            "telephone_number": "410-984-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLENT HEALTHCARE & PSYCHIATRIC REHABILITATION PROGRAM SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "AKPUAKA",
        "authorized_official_first_name": "INNOCENT",
        "authorized_official_title_or_position": "THE PRESIDENT",
        "authorized_official_telephone_number": "410-984-7411"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "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 Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.