Organization
INDEPENDENCE FOUNDATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAVON MAGRUDER (EXECUTIVE DIRECTOR)
(443) 204-1134
Entity
Organization
Contact information
Practice address
13 S. CARROLLTON AVE, BALTIMORE, MD 21223
(443) 204-1134
Mailing address
13 S CARROLLTON AVE, BALTIMORE, MD 21223-2626
(410) 685-0162
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1700
MD
Other
Enumeration date
10/28/2015
Last updated
10/28/2015
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