NPIMap

Organization Active NPI

Greater Baltimore Behavioral Health Services LLC

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1972246593
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
GREATER BALTIMORE BEHAVIORAL HEALTH SERVICES LLC
Practice address
402 E 25TH St
Baltimore, MD 21218-5304
Phone
(410) 889-3000
NPI assigned
Apr 20, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Authorized official

Name
Mr. Olanrewaju W EttiNPI 1962038075
Title
Ceo
Phone
(410) 889-3000

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 1

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

Addresses

Primary practice location

402 E 25TH St
Baltimore, MD 21218-5304

Mailing address

402 E 25TH St
Baltimore, MD 21218-5304
Phone (410) 889-3000

Other identifiers 1

IdentifierTypeStateIssuer
4108893000MedicaidMD

Other names 1

  • Greater Baltimore Behavioral Health Services LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Greater Baltimore Behavioral Health Services LLC5 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.

Practitioners & affiliated clinicians

Practitioners 2

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": "1650412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650412800000",
    "number": "1972246593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 E 25TH ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185304",
            "telephone_number": "410-889-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 E 25TH ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185304",
            "telephone_number": "410-889-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER BALTIMORE BEHAVIORAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A",
        "authorized_official_last_name": "ETTI",
        "authorized_official_first_name": "OLANREWAJU",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-889-3000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4108893000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Baltimore Behavioral Health Services LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 20, 2022; 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.