Organization
WEST BALTIMORE PACE COMMUNITY COALITION, LLC
Active
Other names
Edenbridge PACE of West Baltimore
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BILLINGSLEY (CHIEF ADMINISTRATION OFFICER)
(617) 594-7753
Entity
Organization
Contact information
Practice address
3201A TIOGA PKWY STE A, BALTIMORE, MD 21215-7987
(443) 961-0796
(443) 961-0797
Mailing address
3201A TIOGA PKWY STE A, BALTIMORE, MD 21215-7987
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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