| Baltimore Crisis Response,inc | |
|
5124 Greenwich Ave Baltimore MD 21229-2314 | |
| (410) 433-5255 | |
| (410) 433-6795 |
| Full Name | Baltimore Crisis Response,inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5124 Greenwich Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Edgar Wiggins (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4104335255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baltimore Crisis Response,inc 5124 Greenwich Ave Baltimore MD 21229-2314 Ph: (410) 433-5255 | Baltimore Crisis Response,inc 5124 Greenwich Ave Baltimore MD 21229-2314 Ph: (410) 433-5255 |
| NPI Number | 1073828182 |
|---|---|
| Provider Enumeration Date | 08/12/2010 |
| Last Update Date | 03/04/2021 |
| Certification Date | 03/04/2021 |
| Medicare PECOS PAC ID | 9032365911 |
|---|---|
| Medicare Enrollment ID | O20231102001507 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073828182 | NPI | - | NPPES |
| 545200700 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LC1757 (Maryland) | Primary |
| Provider Name | Jian Min Zhang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598773954 PECOS PAC ID: 9537245204 Enrollment ID: I20080320000139 |
| Provider Name | Sarah Jacqueline Herts |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093094740 PECOS PAC ID: 9638482987 Enrollment ID: I20150716000924 |
| Provider Name | Geneva M Osteen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548586530 PECOS PAC ID: 0749439446 Enrollment ID: I20160104000122 |
| Provider Name | Diane Ossip |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366687337 PECOS PAC ID: 5991007825 Enrollment ID: I20231102001840 |
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