1285031575 NPI number — R. HUTCHISON., LLC

Table of content: (NPI 1366290421)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285031575 NPI number — R. HUTCHISON., LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
R. HUTCHISON., LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
R.HUTCHISON BEHAVIORAL HEALTH & CONSULTATION SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285031575
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
32351 GEIB RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORDOVA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21625-2363
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-253-2824
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8221 TEAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EASTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21601-7227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-253-2824
Provider Business Practice Location Address Fax Number:
855-273-7002
Provider Enumeration Date:
12/02/2014

Additional Information

Authorized Official

Authorized Official Last Name:
HUTCHISON
Authorized Official First Name:
REBECCA
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
THERAPIST
Authorized Official Telephone Number:
410-253-2824

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  15388 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 752105700 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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