Organization
MOUNT CLARE HEALTHCHOICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAE HOON KIM (CEO)
(410) 929-6334
Entity
Organization
Contact information
Practice address
20300 SENECA MEADOWS PKWY STE 215, GERMANTOWN, MD 20876-7021
(410) 929-6334
Mailing address
3460 QUEENSBOROUGH DR, OLNEY, MD 20832-2545
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
R189134
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
587108500
—
MD
Enumeration date
04/19/2017
Last updated
04/19/2017
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