Provider Demographics
NPI:1154000602
Name:BETTER PATH COMMUNITY OUTREACH CENTER, LLC
Entity type:Organization
Organization Name:BETTER PATH COMMUNITY OUTREACH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TYRA
Authorized Official - Middle Name:V
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-908-9104
Mailing Address - Street 1:2925 LORD BALTIMORE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2654
Mailing Address - Country:US
Mailing Address - Phone:410-788-3800
Mailing Address - Fax:
Practice Address - Street 1:2925 LORD BALTIMORE DR STE 100
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-2654
Practice Address - Country:US
Practice Address - Phone:410-788-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder