Organization
JEM COMPREHENSIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MACE SHADID (CEO/DIRECTOR OF FINANCE & LOGISTICS)
(410) 324-7624
Entity
Organization
Contact information
Practice address
6700 ALEXANDER BELL DR STE 200, COLUMBIA, MD 21046-2105
(410) 324-7624
Mailing address
6700 ALEXANDER BELL DR STE 200, COLUMBIA, MD 21046-2105
(410) 324-7624
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
10/03/2018
Last updated
10/09/2018
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