Organization · NPI-2

Agate Integrated And Behavioral Healthcare Services

Clinic/Center, Rehabilitation, Substance Use Disorder · Baltimore, MD

NPI number1740908243
StatusActive
Last updated in NPPESSep 15, 2023

Details

NPI
1740908243
Entity type
Organization (NPI-2)
Legal business name
Agate Integrated And Behavioral Healthcare Services
Organization subpart
No
Enumeration date
Aug 19, 2022
Certification date
Sep 15, 2023
Last updated
Sep 15, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder––Yes
261QM0850X Clinic/Center, Adult Mental Health––
251B00000X Case Management––

Practice location

2323 Maryland Avenue
Suite 1a
Baltimore, MD 21218

Phone 443-934-0084

Mailing address

2323 Maryland Avenue
Suite 1a
Baltimore, MD 21218-5029

Phone 240-515-4868

Authorized official

Jimoh Adepoju Adebayo
Ceo
2405154868

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