Organization
BROADOR HORIZON, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN E. MATTISON M.B.A. (CEO)
(443) 413-0832
Entity
Organization
Contact information
Practice address
199 PLYMOUTH LN, F, GLEN BURNIE, MD 21061-5652
(443) 413-0832
Mailing address
199 PLYMOUTH LN, F, GLEN BURNIE, MD 21061-5652
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0290
MD
Other
Enumeration date
03/05/2008
Last updated
03/05/2008
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