Organization
DPCS INDEPDENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEJUAN FELDER (PRESIDENT)
(410) 805-1070
Entity
Organization
Contact information
Practice address
1330 SMITH AVE, BALTIMORE, MD 21209-3878
(410) 779-1218
Mailing address
1330 SMITH AVE, BALTIMORE, MD 21209-3878
(410) 779-1218
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
01/19/2024
Last updated
01/19/2024
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