Bonita Health Clinic

NPI #1740822915 in Cheverly, Maryland

Provider Information

NPI Number: 1740822915
Entity Type: Organization
Organization Name: Bonita Health Clinic
Subpart: Yes (part of a larger organization)
Parent Organization: RAJAEE BLACK LLC
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Oct 9, 2019
Last Updated: Oct 9, 2019

Practice Location

Address: 6124 LANDOVER RD
City: Cheverly
State: Maryland
ZIP Code: 20785-1016
Phone: (215) 500-7580

Authorized Official

Name: MR. RAJAEE BLACK, CRNA
Title: PRESIDENT
Phone: (215) 500-7580

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Mental Health — Mental Health	101YM0800X
Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health	363LP0808X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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