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Organization

SHEPPARD PRATT HEALTH SYSTEM, INC

Active
Other names
Jefferson RTC
Organization subpart
No

Provider details

NPI number
Authorized official
MS. BONNIE B. KATZ (VP, CORPORATE BUSINESS DEVELOPMENT)
(410) 938-3154
Entity
Organization

Contact information

Practice address
2940 POINT OF ROCKS RD., JEFFERSON, MD 21755-0009
(301) 624-8400
(301) 624-8404
Mailing address
6501 N CHARLES ST, BALTIMORE, MD 21204-6819
(410) 938-3000
(410) 938-3159

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
10-018
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
081505500
MD
Enumeration date
10/02/2006
Last updated
01/16/2009
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