# MISTAKEN IDENTITY CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528412590
- **Authorized official:** MRS. SHERI GREEN (FOUNDER & CHAIR)
- **Authorized official phone:** (301) 298-5543

## Contact information

- **Practice address:** 9701 APOLLO DR, SUITE 301, LARGO, MD 20774-4783
- **Practice address phone:** (301) 298-5543
- **Mailing address:** 9701 APOLLO DR, SUITE 301, LARGO, MD 20774-4783
- **Mailing address phone:** (301) 298-5543

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |

## Other

- **Enumeration date:** 04/15/2016
- **Last updated:** 04/15/2016