| Profound Visionz Organization Llc | |
|
2300 Garrison Blvd Ste 107 Baltimore MD 21216-2308 | |
| (410) 202-3760 | |
| Not Available |
| Full Name | Profound Visionz Organization Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2300 Garrison Blvd Ste 107, Baltimore, Maryland |
| Authorized Official Name and Position | Tumpei Troie Pollard-jackson (OWNER) |
| Authorized Official Contact | 4432541884 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Profound Visionz Organization Llc 2300 Garrison Blvd Ste 107 Baltimore MD 21216-2308 Ph: (410) 202-3760 | Profound Visionz Organization Llc 2300 Garrison Blvd Ste 107 Baltimore MD 21216-2308 Ph: (410) 202-3760 |
| NPI Number | 1104658111 |
|---|---|
| Provider Enumeration Date | 08/19/2024 |
| Last Update Date | 08/19/2024 |
| Certification Date | 08/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104658111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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