Organization
HARWOOD HEALTH
Active
Parent organization
CCG MANAGEMENT LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CCG MANAGEMENT LLC
Authorized official
MS. BARBARA A WAHL RN, MA (BUSINESS OPERATIONS DIRECTOR)
(667) 239-3205
Entity
Organization
Contact information
Practice address
428 E 25TH ST, BALTIMORE, MD 21218-5304
(410) 617-0142
(443) 873-6975
Mailing address
428 E 25TH ST, BALTIMORE, MD 21218-5304
(410) 617-0142
(443) 873-6975
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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