Healthcare Provider Details

I. General information

NPI: 1386463842
Provider Name (Legal Business Name): ANNE ARUNDEL COUNTY, MARYLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2024
Last Update Date: 10/10/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2666 RIVA RD SUITE 400 ATTN: ALAGRA BASS OR JOELLE RIDGEWAY/MENTAL HEALTH PROG
ANNAPOLIS MD
21401
US

IV. Provider business mailing address

7320 RITCHIE HIGHWAY ATTN: ALAGRA BASS OR JOELLE RIDGEWAY/MENTAL HEALTH PROG
GLEN BURNIE MD
21061
US

V. Phone/Fax

Practice location:
  • Phone: 410-222-4257
  • Fax: 410-222-4360
Mailing address:
  • Phone: 443-760-7916
  • Fax: 410-222-4360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. CHRISTINE ANDERSON
Title or Position: CHIEF ADMINISTRATION OFFICER
Credential:
Phone: 410-222-2878