OrganizationActive
Adult Behavioral Health Program
NPI 1477639631 · Health Maintenance Organization · Wheaton, MD
Provider details
- NPI number
- 1477639631
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Randall Ingate, Clinical Supervisor(240) 777-1384
- License
- 265391500 (MD)
Specialties & taxonomies
Managed Care Organizations
Practice location
2424 Reedie Dr Fl 3
Wheaton, MD 20902-4624
Phone: (240) 777-1323
Fax: (240) 777-3226
Approximate (ZIP-level) locationGet directions
Mailing address
2424 Reedie Dr Fl 3
Wheaton, MD 20902-4624
Registry dates
- Enumerated
- 2006-10-31
- Last updated
- 2008-06-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.