| Msbc Five Star Program Inc | |
|
6665 Security Blvd Woodlawn MD 21207-4018 | |
| (410) 265-7291 | |
| (410) 265-7294 |
| Full Name | Msbc Five Star Program Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 6665 Security Blvd, Woodlawn, Maryland |
| Authorized Official Name and Position | Charisse Kianna Mercer (OFFICE MANGER) |
| Authorized Official Contact | 4102657291 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Msbc Five Star Program Inc 6665 Security Blvd Woodlawn MD 21207-4018 Ph: (410) 265-7291 | Msbc Five Star Program Inc 6665 Security Blvd Woodlawn MD 21207-4018 Ph: (410) 265-7291 |
| NPI Number | 1427256379 |
|---|---|
| Provider Enumeration Date | 07/03/2007 |
| Last Update Date | 02/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427256379 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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