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Organization
WOODBOURNE SCHOOL
Active
Organization
WOODBOURNE SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY WILSON (EXECUTIVE DIRECTOR)
(410) 433-1000
Entity
Organization
Contact information
Practice address
1301 WOODBOURNE AVE, BALTIMORE, MD 21239-3316
(410) 433-1000
(410) 433-1459
Mailing address
1301 WOODBOURNE AVE, BALTIMORE, MD 21239-3316
(410) 433-1000
(410) 433-1459
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
3875
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
235395400
—
MD
Enumeration date
06/16/2016
Last updated
06/16/2016
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