Provider Demographics
NPI:1598580920
Name:STILL WATERS HEALTH SYSTEMS LLC
Entity type:Organization
Organization Name:STILL WATERS HEALTH SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIU
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-202-1094
Mailing Address - Street 1:3030 GREENMOUNT AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-6935
Mailing Address - Country:US
Mailing Address - Phone:443-822-2970
Mailing Address - Fax:
Practice Address - Street 1:3030 GREENMOUNT AVE STE 150
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-6935
Practice Address - Country:US
Practice Address - Phone:443-822-2970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health