Concerted Care Group Brooklyn LLC

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

License

MD-10167M Issued in MD

Legal business name

CONCERTED CARE GROUP BROOKLYN LLC

Practice address

112 E Patapsco Ave
Baltimore, MD 21225-1745

Phone

(240) 813-9867

NPI assigned

Sep 1, 2017

Last updated

Aug 20, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Keonna Armstrong

Title

VP of Cycle Management

Phone

(240) 813-9867

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MD

Opioid treatment program

Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Tax ID family

Concerted Care Group Brooklyn LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Concerted Care Group Brooklyn

  • Clinic/Center
  • Baltimore, MD
  • NPI 1730612235
  NPD tax ID
• Concerted Care Group Brooklyn LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Baltimore, MD
  • NPI 1730790494
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Erika N Kane, MD

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1659300135
  NPD (past)

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

{
    "created_epoch": "1504224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1972021681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 E 25TH ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185304",
            "telephone_number": "240-813-9867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E PATAPSCO AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212251745",
            "telephone_number": "240-813-9867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCERTED CARE GROUP BROOKLYN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-01",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "KEONNA",
        "authorized_official_title_or_position": "VP OF CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "240-813-9867"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "MD",
            "license": "MD-10167M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHMH CERTIFICATION",
            "identifier": "MD-10167M",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@concertedcaregroup.com",
            "affiliation": "N",
            "address_1": "112 E Patapsco Ave",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212251745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Concerted Care Group Baltimore Substance Use Services
• Concerted Care Group Baltimore, LLC
• Concerted Care Group Baltimore, LLC
• Concerted Care Group Brooklyn
• Concerted Care Group Brooklyn LLC
• Concerted Care Group Management LLC (CCG Management, LLC)
• Concerted Care Group Management LLC (CCG management, LLC)
• Concerted Care Group Management LLC (CCG Managmen, LLC)
• Concerted Care Group Management LLC (CCG Management, LLC)
• Concerted Care Group Management LLC (CCG Management, LLC)

• Methadone Clinic in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Methadone Clinic in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.