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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. AFREKA LYNCH (CEO)
(443) 408-8045
Entity
Organization

Contact information

Practice address
8304 HARFORD RD, 2ND FOOR, PARKVILLE, MD 21234-5700
(443) 408-8045
Mailing address
8304 HARFORD RD, 2ND FOOR, PARKVILLE, MD 21234
(443) 408-8045

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
251X00000X
Supports Brokerage Agency
253Z00000X
In Home Supportive Care Agency
310400000X
Assisted Living Facility
Primary
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Enumeration date
07/12/2016
Last updated
07/12/2016
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