Organization
DAVID'S LOFT CLINICAL PROGRAMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID H. THOMPSON JR. (CEO)
(410) 800-4226
Entity
Organization
Contact information
Practice address
2641 MARYLAND AVENUE, BALTIMORE, MD 21218
(410) 800-4226
(410) 387-7637
Mailing address
2641 MARYLAND AVENUE, BALTIMORE, MD 20715
(410) 800-4226
(410) 387-7637
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC2650
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
908601301
—
MD
Enumeration date
02/11/2012
Last updated
02/15/2022
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