Organization
1HIE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY WILLIAMS (CHIEF OPERATIONS OFFICER)
(301) 642-0070
Entity
Organization
Contact information
Practice address
345 PLEASANTON RD APT 11, WESTMINSTER, MD 21157-9484
(443) 939-7879
Mailing address
345 PLEASANTON RD APT 11, WESTMINSTER, MD 21157-9484
(301) 642-0070
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
07/25/2024
Last updated
07/25/2024
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