| For The Healing Of The Nations Llc | |
|
3635 Old Court Rd Ste 305 Pikesville MD 21208-3907 | |
| (443) 717-0130 | |
| (443) 327-4753 |
| Full Name | For The Healing Of The Nations Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3635 Old Court Rd Ste 305, Pikesville, Maryland |
| Authorized Official Name and Position | Suzanne M Matsko (OWNER) |
| Authorized Official Contact | 4437170130 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| For The Healing Of The Nations Llc 3635 Old Court Rd Ste 305 Pikesville MD 21208-3907 Ph: (443) 717-0130 | For The Healing Of The Nations Llc 3635 Old Court Rd Ste 305 Pikesville MD 21208-3907 Ph: (443) 717-0130 |
| NPI Number | 1417476607 |
|---|---|
| Provider Enumeration Date | 09/19/2017 |
| Last Update Date | 10/23/2019 |
| Medicare PECOS PAC ID | 3971858762 |
|---|---|
| Medicare Enrollment ID | O20180619002855 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417476607 | NPI | - | NPPES |
| 105778200 | Medicaid | MD | |
| CX87-0001 | Other | MD | CAREFIRST BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Suzanne Marie Matsko |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932228608 PECOS PAC ID: 0244259364 Enrollment ID: I20051117000985 |
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