# SHEPPARD PRATT HEALTH SYSTEM, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jefferson RTC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255424164
- **Authorized official:** MS. BONNIE B. KATZ (VP, CORPORATE BUSINESS DEVELOPMENT)
- **Authorized official phone:** (410) 938-3154

## Contact information

- **Practice address:** 2940 POINT OF ROCKS RD., JEFFERSON, MD 21755-0009
- **Practice address phone:** (301) 624-8400
- **Practice address fax:** (301) 624-8404
- **Mailing address:** 6501 N CHARLES ST, BALTIMORE, MD 21204-6819
- **Mailing address phone:** (410) 938-3000
- **Mailing address fax:** (410) 938-3159

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 10-018 | MD | Yes |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 01/16/2009