| Process Of Changes | |
|
1000 Ingleside Ave Ste 1 Catonsville MD 21228-1317 | |
| (443) 551-3784 | |
| (443) 551-3801 |
| Full Name | Process Of Changes |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1000 Ingleside Ave Ste 1, Catonsville, Maryland |
| Authorized Official Name and Position | Paula Ohiku (DIRECTOR) |
| Authorized Official Contact | 4104047651 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Process Of Changes 1000 Ingleside Ave Catonsville MD 21228-1317 Ph: (443) 551-3784 | Process Of Changes 1000 Ingleside Ave Ste 1 Catonsville MD 21228-1317 Ph: (443) 551-3784 |
| NPI Number | 1720641509 |
|---|---|
| Provider Enumeration Date | 04/17/2019 |
| Last Update Date | 05/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720641509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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