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Organization
SHEPPARD PRATT HEALTH SYSTEM, INC.
Active
Organization
SHEPPARD PRATT HEALTH SYSTEM, INC.
Active
Other names
Forbush School at Glyndon
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
407 CENTRAL AVE, REISTERSTOWN, MD 21136-1854
(410) 517-5400
(410) 517-5600
Mailing address
6501 N CHARLES ST, BALTIMORE, MD 21204-6819
(410) 938-3150
(410) 938-3159
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
03-64551
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
681500600
—
MD
Enumeration date
01/23/2007
Last updated
08/10/2009
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