Provider Demographics
NPI:1063971158
Name:AMITY MENTAL HEALTH AND WELLNESS CENTER LLC
Entity type:Organization
Organization Name:AMITY MENTAL HEALTH AND WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ADETENIOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEBAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-312-7273
Mailing Address - Street 1:1829 REISTERSTOWN RD STE 350
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-7126
Mailing Address - Country:US
Mailing Address - Phone:410-230-1819
Mailing Address - Fax:410-230-1820
Practice Address - Street 1:1829 REISTERSTOWN RD STE 350
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-7126
Practice Address - Country:US
Practice Address - Phone:410-230-1819
Practice Address - Fax:410-230-1820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health