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Contact Information

BLUE BALLOON INDIAN CREEK LLC
12240 INDIAN CREEK CT STE 100
BELTSVILLE, MD20705-1242
 Phone: 201-216-9500
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Behavior Analyst

103K00000X
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for BLUE BALLOON INDIAN CREEK LLC

NPI Number 1073365243
LBN Legal business name BLUE BALLOON INDIAN CREEK LLC
Authorized official MARIAM NEWMARK - (CLINICAL DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 04/02/2024
Last updated 04/02/2024 - About 2 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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