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GREEN RIDGE BEHAVIORAL HEALTH LLC NPI 1609283050


NPI Information

NPI: 1609283050
Provider Name: GREEN RIDGE BEHAVIORAL HEALTH, LLC
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

CLIA Number: 21D2036158

Address:
5216 CHAIRMANS COURT
SUITE 102
FREDERICK, MD
ZIP 21703
Phone: (240) 683-6202
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GREEN RIDGE BEHAVIORAL HEALTH, LLC is a neurology psychiatry neurology in Frederick, MD. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. GREEN RIDGE BEHAVIORAL HEALTH, LLC NPI is 1609283050. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5216 CHAIRMANS COURT
SUITE 102
FREDERICK, MD
ZIP 21703
Phone: (240) 683-6202
Fax: (240) 683-6203

The provider's authorized official is Narayanan Ramesh .
The authorized official title is Partner and has the following contact phone number (240) 683-6202.

The CLIA number assigned to this NPI record is 21D2036158 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/17/2014 and was last updated on 7/17/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0400XPsychiatry & NeurologyNeurologyD0056459MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1182421MEDICARE PINDISTRICT OF COLUMBIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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