Organization
MISTAKEN IDENTITY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERI GREEN (FOUNDER & CHAIR)
(301) 298-5543
Entity
Organization
Contact information
Practice address
9701 APOLLO DR, SUITE 301, LARGO, MD 20774-4783
(301) 298-5543
Mailing address
9701 APOLLO DR, SUITE 301, LARGO, MD 20774-4783
(301) 298-5543
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/15/2016
Last updated
04/15/2016
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