Provider Demographics
NPI:1578219515
Name:HEALTH PLUS BEHAVIORAL AND PRIMARY CARE
Entity type:Organization
Organization Name:HEALTH PLUS BEHAVIORAL AND PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMDEM-SANGO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:433-544-4774
Mailing Address - Street 1:115 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3013
Mailing Address - Country:US
Mailing Address - Phone:443-354-4477
Mailing Address - Fax:
Practice Address - Street 1:115 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3013
Practice Address - Country:US
Practice Address - Phone:443-354-4477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-28
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health