Organization
ADOLAIZE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TASHIMA THOMAS LCSW-C (CLINICAL DIRECTOR)
(443) 219-7878
Entity
Organization
Contact information
Practice address
5900 YORK RD STE 203, BALTIMORE, MD 21212-3040
(443) 219-7878
Mailing address
PO BOX 5030, STE 5030, CHARLOTTE, NC 28299-2201
(443) 219-7878
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
489009400
—
MD
Enumeration date
05/31/2020
Last updated
08/05/2025
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