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Organization
ATLAS HEALTH, LLC
Active
Organization
ATLAS HEALTH, LLC
Active
Other names
CloseKnit
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JANE FAVAZZA (CEO)
(410) 528-7109
Entity
Organization
Contact information
Practice address
1501 S CLINTON ST, BALTIMORE, MD 21224-5730
(410) 528-7109
Mailing address
1501 S CLINTON ST, BALTIMORE, MD 21224-5730
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
NULL
171M00000X
Case Manager/Care Coordinator
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
06/21/2021
Last updated
08/08/2024
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