Organization
PROGRESSIVE WALK OF MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAJOIE GRIMES JR. (ASSISTANT DIRECTOR)
(410) 889-7500
Entity
Organization
Contact information
Practice address
2508 N CALVERT ST, BALTIMORE, MD 21218-4614
(410) 889-7500
Mailing address
2508 N CALVERT ST, BALTIMORE, MD 21218-4614
(410) 889-7500
(410) 889-4501
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
410339400
—
MD
05
—
411626700
—
MD
Enumeration date
02/28/2008
Last updated
06/03/2008
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