Organization · NPI-2

Community Based Sevices Prp At Equanimity

Community/Behavioral Health · White Plains, MD

NPI number1417879420
StatusActive
Last updated in NPPESJul 29, 2026

Details

NPI
1417879420
Entity type
Organization (NPI-2)
Legal business name
Community Based Sevices Prp At Equanimity
Organization subpart
No
Enumeration date
Jul 29, 2026
Certification date
Jul 29, 2026
Last updated
Jul 29, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral Health––Yes

Practice location

10665 Stanhaven Pl
White Plains, MD 20695-3055

Phone 404-980-4808 · Fax 240-241-6360

Mailing address

10665 Stanhaven Pl
White Plains, MD 20695-3055

Phone 404-980-4808 · Fax 240-241-6360

Authorized official

Tavin Parker
Member
4049804808

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