CENTER FOR COMMUNITY BALANCE, INC. (NPI# 1245683010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245683010 |
| Entity Type | Organization |
| Organization Name | CENTER FOR COMMUNITY BALANCE, INC. |
| Practice Address |
413 Commonwealth Ave Suite #7 Catonsville MD 21228-3044 |
| Practice Telephone | 4106154312 |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |
| Authorized Official Name | MR. OLUWAFEMI SHODIPE (PRESIDENT/CEO) |
| Authorized Official Telephone | 4106154312 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
MH-2061 | MD | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | OHCQ | 2061 | 01 |
| MD | APPROVAL NO | 2061 | 01 |
| Street Address |
413 COMMONWEALTH AVE SUITE #7 |
| City | CATONSVILLE |
| State | MD |
| Zip Code | 21228-3044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073051918 | Faith Health Care Center | Nurse Practitioner | 413 Commonwealth Ave, Suite 7, Catonsville, MD 21228-3044 | 2017-02-10 |
| 1992170468 | Iyabode O Fadeyi | Counselor | 413 Commonwealth Ave, Ste 7, Catonsville, MD 21228 | 2015-12-09 |
| 1487935417 | Faith Health Care Center | Clinic/Center | 413 Commonwealth Ave, Suite 3, Catonsville, MD 21228-3044 | 2011-09-03 |
| 1811065030 | Miguel A Heredia | Internal Medicine | 413 Commonwealth Ave, Catonsville, MD 21228-3044 | 2006-12-04 |
| 1790757326 | Willie B Mvemba | Specialist | 413 Commonwealth Ave, Suite 3, Catonsville, MD 21228-3044 | 2006-02-07 |
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| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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|---|---|---|---|---|
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| City | CATONSVILLE |
| Zip Code | 21228 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.