Organization
MSBC FIVE STAR PROGRAM INC
Active
Other names
The Renaissance Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARISSE KIANNA MERCER (OFFICE MANGER)
(410) 265-7291
Entity
Organization
Contact information
Practice address
6665 SECURITY BLVD, WOODLAWN, MD 21207-4018
(410) 265-7291
(410) 265-7294
Mailing address
6665 SECURITY BLVD, WOODLAWN, MD 21207-4018
(410) 265-7291
(410) 265-7294
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
07/03/2007
Last updated
02/10/2014
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