Organization
MADONNA HEALTHCARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NKEM EGUDIA (CEO/PROGRAM DIRECTOR)
(410) 233-4039
Entity
Organization
Contact information
Practice address
2300 GARRISON BLVD STE 230, BALTIMORE, MD 21216-2377
(410) 233-4039
(410) 233-4052
Mailing address
2300 GARRISON BLVD STE 230, BALTIMORE, MD 21216-2377
(410) 233-4039
(410) 233-4052
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4793
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420235000
—
MD
Enumeration date
12/20/2010
Last updated
05/25/2021
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