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Organization
SHEPPARD PRATT HEALTH SYSTEM, INC.
Active
Organization
SHEPPARD PRATT HEALTH SYSTEM, INC.
Active
Other names
Jefferson School
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
2940 POINT OF ROCKS ROAD, JEFFERSON, MD 21755-0009
(301) 629-8400
(301) 629-8404
Mailing address
6501 NORTH CHARLES STREET, BALTIMORE, MD 21204-6819
(410) 938-3000
(410) 938-3159
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
3801
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201901900
—
MD
Enumeration date
01/23/2007
Last updated
01/16/2009
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