Organization
MARYLAND SUCCESS ACADEMY LLC
Active
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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