Organization
LIVINGONOUROWN
Active
Organization
LIVINGONOUROWN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHASTITY ROCQUEMORE (CEO)
(443) 931-9919
Entity
Organization
Contact information
Practice address
5665 LEIDEN RD, BALTIMORE, MD 21206-2916
(443) 931-9919
Mailing address
5665 LEIDEN RD, BALTIMORE, MD 21206-2916
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
DC
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
DC
251S00000X
Community/Behavioral Health Agency
—
DC
Other
Enumeration date
09/23/2014
Last updated
03/23/2016
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