NPIMap

Organization Active NPI

MMBR Behavioral Health Services Inc

  • Substance Abuse Rehabilitation Facility
  • Brooklym, MD
National Provider Identifier
1962263665
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
MMBR BEHAVIORAL HEALTH SERVICES INC
Practice address
3804 S. Hanover Street
Brooklym, MD 20774
Phone
(301) 655-5086
NPI assigned
Jan 19, 2024
Last updated
Jan 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Authorized official

Name
Bola Yusuf
Title
Owner
Phone
(301) 655-5086

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

3804 S. Hanover Street
Brooklym, MD 20774

Mailing address

3804 S. Hanover Street
Brooklyn, MD 21225-2122
Phone (301) 655-5086

National Provider Directory

National Provider Directory
Tax ID family
MMBR Behavioral Health 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.

NPI Registry JSON

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1962263665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3804 S. HANOVER STREET",
            "city": "BROOKLYN",
            "state": "MD",
            "postal_code": "212252122",
            "telephone_number": "301-655-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 S. HANOVER STREET",
            "city": "BROOKLYM",
            "state": "MD",
            "postal_code": "20774",
            "telephone_number": "301-655-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMBR BEHAVIORAL HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "YUSUF",
        "authorized_official_first_name": "BOLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-655-5086"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.