Provider Demographics
NPI:1194449561
Name:BREATHE FREELY BEHAVIORAL HEALTH SYSTEMS, LLC
Entity type:Organization
Organization Name:BREATHE FREELY BEHAVIORAL HEALTH SYSTEMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TANIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER.
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-670-9860
Mailing Address - Street 1:6600 BELAIR RD STE 1A
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-1855
Mailing Address - Country:US
Mailing Address - Phone:443-766-5825
Mailing Address - Fax:
Practice Address - Street 1:6600 BELAIR RD STE 1A1B
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-1855
Practice Address - Country:US
Practice Address - Phone:443-766-5825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-29
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)