Organization
FIRST BASE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARQUITA THOMAS (EXECUTIVE DIRECTOR)
(443) 683-7696
Entity
Organization
Contact information
Practice address
920 PROVIDENCE RD STE 407, TOWSON, MD 21286-2979
(410) 705-7224
Mailing address
920 PROVIDENCE RD STE 407, TOWSON, MD 21286-2979
(410) 705-7224
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/12/2023
Last updated
09/27/2024
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