Organization
JACOBS PROMISE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN WINSTON (BCBA)
(301) 576-5487
Entity
Organization
Contact information
Practice address
15480 ANNAPOLIS RD STE 202, BOWIE, MD 20715-1803
(301) 392-7075
Mailing address
15480 ANNAPOLIS RD STE 202, BOWIE, MD 20715-1803
(301) 392-7075
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
ZZ 103K00000X
MD
Other
Enumeration date
12/26/2016
Last updated
12/26/2016
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