| Buntu Behavioral Health Services | |
|
2124 Nicole Way Abingdon MD 21009-3049 | |
| (667) 334-0779 | |
| Not Available |
| Full Name | Buntu Behavioral Health Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 2124 Nicole Way, Abingdon, Maryland |
| Authorized Official Name and Position | David Maina (PRESIDENT) |
| Authorized Official Contact | 6673340779 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Buntu Behavioral Health Services 2124 Nicole Way Abingdon MD 21009-3049 Ph: (667) 334-0779 | Buntu Behavioral Health Services 2124 Nicole Way Abingdon MD 21009-3049 Ph: (667) 334-0779 |
| NPI Number | 1336881606 |
|---|---|
| Provider Enumeration Date | 04/08/2022 |
| Last Update Date | 04/08/2022 |
| Certification Date | 04/08/2022 |
| Medicare PECOS PAC ID | 1557749819 |
|---|---|
| Medicare Enrollment ID | O20220528000071 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336881606 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (NU) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (NU) | Secondary |
| Provider Name | David Maina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134746910 PECOS PAC ID: 2163812165 Enrollment ID: I20211207000428 |
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