| Vidaluxlook | |
|
1611 Parkridge Cir Apt 194 Crofton MD 21114-2817 | |
| (240) 838-9219 | |
| Not Available |
| Full Name | Vidaluxlook |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1611 Parkridge Cir Apt 194, Crofton, Maryland |
| Authorized Official Name and Position | Jenifer K Guinn (COMMUNITY SUPPORT WORKER) |
| Authorized Official Contact | 2408389219 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vidaluxlook 1611 Parkridge Cir Apt 194 Crofton MD 21114-2817 Ph: (240) 838-9219 | Vidaluxlook 1611 Parkridge Cir Apt 194 Crofton MD 21114-2817 Ph: (240) 838-9219 |
| NPI Number | 1841007291 |
|---|---|
| Provider Enumeration Date | 12/18/2024 |
| Last Update Date | 12/18/2024 |
| Certification Date | 12/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841007291 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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