Organization
VINE RESIDENTIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCUS MOTTON (PROGRAM DIRECTOR)
(443) 473-9773
Entity
Organization
Contact information
Practice address
707 NORRIS LN, ESSEX, MD 21221-2140
(443) 473-9773
(443) 961-8169
Mailing address
703 N CAREY ST, BALTIMORE, MD 21217-2412
(443) 473-9773
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
01/15/2025
Last updated
01/15/2025
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