Organization
SUCCESSFUL RESOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID MILES BSW (EXECUTIVE DIRECTOR)
(410) 426-4600
Entity
Organization
Contact information
Practice address
6716 HARFORD RD, BALTIMORE, MD 21234-7708
(410) 426-4600
(410) 426-4500
Mailing address
3122 NORTHWAY DR, PARKVILLE, MD 21234-7825
(410) 426-4600
(410) 426-4500
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
10974207
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
714002900
—
MD
Enumeration date
03/14/2007
Last updated
07/31/2007
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