Provider Demographics
NPI:1720782352
Name:HARWOOD BEHAVIORAL HEALTH II LLC
Entity type:Organization
Organization Name:HARWOOD BEHAVIORAL HEALTH II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:667-239-3293
Mailing Address - Street 1:3905 NATIONAL DR
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-1100
Mailing Address - Country:US
Mailing Address - Phone:667-239-3293
Mailing Address - Fax:
Practice Address - Street 1:1275 W PULASKI HWY STE B
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-4719
Practice Address - Country:US
Practice Address - Phone:667-239-3293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CCG HOLDCO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-28
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health