Organization · NPI-2
Upstream Journeys LLC
Clinic/Center, Adult Mental Health · Belcamp, MD
NPI number1295565190
StatusActive
Last updated in NPPESAug 5, 2024
Details
- NPI
- 1295565190
- Entity type
- Organization (NPI-2)
- Legal business name
- Upstream Journeys LLC
- Organization subpart
- No
- Enumeration date
- Aug 5, 2024
- Certification date
- Aug 5, 2024
- Last updated
- Aug 5, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | Yes |
Practice location
4690 Millennium Dr Ste 300Belcamp, MD 21017-1527
Phone 410-888-7740
Mailing address
4690 Millennium Dr Ste 300Belcamp, MD 21017-1527
Phone 410-888-7740
Authorized official
Jendayi Gantt
Practice Owner
4108887740
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