Provider Demographics
NPI:1720812787
Name:COMMUNITY BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:COMMUNITY BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BHAYANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-224-5264
Mailing Address - Street 1:426 DORCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-2446
Mailing Address - Country:US
Mailing Address - Phone:844-224-5264
Mailing Address - Fax:888-509-0010
Practice Address - Street 1:821 EASTERN SHORE DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-5943
Practice Address - Country:US
Practice Address - Phone:844-224-5264
Practice Address - Fax:888-509-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)