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Organization

SHEPPARD PRATT HEALTH SYSTEM, INC.

Active
Other names
Forbush School at Anne Arundel
Organization subpart
No

Provider details

NPI number
Authorized official
MS. BONNIE B. KATZ (VP, BUS DEVELOPMENT & SUPPORT OPS)
(410) 938-3150
Entity
Organization

Contact information

Practice address
648 OLD MILL RD, MILLERSVILLE, MD 21108-1373
(410) 729-9181
(410) 729-3159
Mailing address
6501 N CHARLES ST, BALTIMORE, MD 21204-6819
(410) 938-3000

Taxonomy

Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
LETTER
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LETTER OF LICENSE
MD SPECIAL EDUCATION LICENSE
MD
Enumeration date
10/19/2009
Last updated
10/19/2009
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