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Organization
SHEPPARD PRATT HEALTH SYSTEM, INC.
Active
Organization
SHEPPARD PRATT HEALTH SYSTEM, INC.
Active
Other names
Jefferson School at Eckhart
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BONNIE B KATZ (VP CORPORATE BUSINESS DEVELOPMENT)
(410) 938-3150
Entity
Organization
Contact information
Practice address
17000 NATIONAL HWY NW, FROSTBURG, MD 21532-3206
(301) 777-2258
(301) 777-2364
Mailing address
6501 N CHARLES ST, BALTIMORE, MD 21204-6819
(410) 938-3150
(410) 938-3159
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
0000
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000
TENTATIVE APPR LTR
MD
Enumeration date
01/23/2007
Last updated
01/16/2009
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