Organization
CHANGING DIRECTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TASHA SAUNDERS (PROGRAM ADMINISTRATOR)
(443) 333-4777
Entity
Organization
Contact information
Practice address
1900 E NORTHERN PKWY, SUITE 310, BALTIMORE, MD 21239-2113
(443) 333-4777
(443) 333-4778
Mailing address
1900 E NORTHERN PKWY, SUITE 310, BALTIMORE, MD 21239-2113
(443) 333-4777
(443) 333-4778
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
04/17/2015
Last updated
04/01/2016
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