MEDICARE: HOLDING SPACE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1609748763
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLDING SPACE LLC

Provider Business Mailing Address
First Line	:	12313 SURREY CIRCLE DR
Second Line	:
City	:	FT WASHINGTON
State	:	MD
Zip	:	20744-6229
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12313 SURREY CIRCLE DR
Second Line	:
City	:	FT WASHINGTON
State	:	MD
Zip	:	20744-6229
Country	:	US
Telephone Number	:	443-538-3973
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	SHERYL DANIEL
Credential	:
Telephone Number	:	443-538-3973

Provider Enumeration Date	:	09/18/2025
Last Update Date	:	09/18/2025

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Directions to “HOLDING SPACE LLC ” Practice Location

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