Primal Health Clinic LLC

NPI #1912543026 in Essex, Maryland

Provider Information

NPI Number: 1912543026
Entity Type: Organization
Organization Name: Primal Health Clinic LLC
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Nov 24, 2019
Last Updated: Jul 19, 2021

Practice Location

Address: 449 HOPKINS LANDING DR
City: Essex
State: Maryland
ZIP Code: 21221-2229
Phone: (443) 600-0181

Authorized Official

Name: JON KOGAN
Title: ADMINISTRATOR
Phone: (443) 253-5533

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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