Organization
LOLA'S VILLAGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORA WOLZ (OWNER)
(301) 325-6196
Entity
Organization
Contact information
Practice address
4502 SCHENLEY RD, BALTIMORE, MD 21210-2524
(443) 961-6633
Mailing address
4502 SCHENLEY RD # 100A, BALTIMORE, MD 21210-2524
(443) 961-6633
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/17/2020
Last updated
01/17/2020
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