Provider Demographics
NPI:1942768528
Name:AMERICAN PSYCHIATRIC CARE LLC
Entity type:Organization
Organization Name:AMERICAN PSYCHIATRIC CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAVIKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:BHALAVAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-670-3076
Mailing Address - Street 1:63 E MAIN ST STE 6
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5036
Mailing Address - Country:US
Mailing Address - Phone:410-848-8202
Mailing Address - Fax:410-848-2644
Practice Address - Street 1:8895 CENTRE PARK DR STE E2
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1966
Practice Address - Country:US
Practice Address - Phone:410-670-3076
Practice Address - Fax:443-372-5365
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN PSYCHIATRIC CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-04
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD661214800Medicaid