Organization
FOUNDATIONS FOR SUCCESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SHAMIRAH NATARSHA JACKSON LMSW (PROGRAM ADMINISTRATOR)
(240) 600-0942
Entity
Organization
Contact information
Practice address
367 MARYDELL RD, BALTIMORE, MD 21229-4108
(240) 600-0942
Mailing address
367 MARYDELL RD, BALTIMORE, MD 21229-4108
(240) 600-0942
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/19/2022
Last updated
03/19/2022
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