| Prosper Health And Behavioral Care Services | |
|
3934 Red Deer Circle Randallstown MD 21133 | |
| (443) 799-4247 | |
| Not Available |
| Full Name | Prosper Health And Behavioral Care Services |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3934 Red Deer Circle, Randallstown, Maryland |
| Authorized Official Name and Position | Juliana Ada Mccullough (CEO) |
| Authorized Official Contact | 4437994247 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prosper Health And Behavioral Care Services 3934 Red Deer Circle Randallstown MD 21133 Ph: (443) 799-4247 | Prosper Health And Behavioral Care Services 3934 Red Deer Circle Randallstown MD 21133 Ph: (443) 799-4247 |
| NPI Number | 1801572722 |
|---|---|
| Provider Enumeration Date | 06/26/2023 |
| Last Update Date | 06/26/2023 |
| Certification Date | 06/26/2023 |
| Medicare PECOS PAC ID | 1951764471 |
|---|---|
| Medicare Enrollment ID | O20230831002143 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801572722 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Juliana Ada Mccullough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437845013 PECOS PAC ID: 2668834698 Enrollment ID: I20230808002630 |
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