Organization
MARYLAND SUCCESS ACADEMY LLC
Active
Other names
Maryland Success Lab, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER HUBBARD (PRESIDENT)
(443) 353-9729
Entity
Organization
Contact information
Practice address
9854 LIBERTY RD, SUITE E, RANDALLSTOWN, MD 21133-2113
(443) 353-9729
Mailing address
9854 LIBERTY RD, SUITE E, RANDALLSTOWN, MD 21133-2058
(443) 353-9729
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
07/23/2020
Last updated
10/26/2021
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