Provider Demographics
NPI:1487911889
Name:NEW VISION BEHAVIORAL HEALTH SERVICES INC
Entity type:Organization
Organization Name:NEW VISION BEHAVIORAL HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTANG
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:443-326-2344
Mailing Address - Street 1:5718 HARFORD RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-2237
Mailing Address - Country:US
Mailing Address - Phone:410-254-4343
Mailing Address - Fax:410-254-4342
Practice Address - Street 1:4710 PENNINGTON AVE
Practice Address - Street 2:2ND FLOOR, SUITE 3
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21226-1405
Practice Address - Country:US
Practice Address - Phone:410-254-4343
Practice Address - Fax:410-254-4342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD5791251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health