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Organization
THE HOUSE OF THE GOOD SHEPHERD OF THE CITY OF BALTIMORE
Active
Organization
THE HOUSE OF THE GOOD SHEPHERD OF THE CITY OF BALTIMORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK A. BOONE PSY.D. (PRESIDENT & CEO)
(410) 247-2770
Entity
Organization
Contact information
Practice address
4100 MAPLE AVENUE, BALTIMORE, MD 21227-4007
(410) 247-2770
(410) 247-3242
Mailing address
4100 MAPLE AVENUE, BALTIMORE, MD 21227-4007
(410) 247-2770
(410) 247-3242
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
03-049
MD
Other
Enumeration date
03/19/2007
Last updated
05/13/2009
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