Healthcare Provider Details

I. General information

NPI: 1205308996
Provider Name (Legal Business Name): ABOVE ALL ODDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2018
Last Update Date: 12/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 E LEXINGTON ST STE 400
BALTIMORE MD
21202-1723
US

IV. Provider business mailing address

11 E LEXINGTON ST STE 400
BALTIMORE MD
21202-1723
US

V. Phone/Fax

Practice location:
  • Phone: 443-708-5699
  • Fax:
Mailing address:
  • Phone: 443-708-5699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MR. TURNER RASCOE III
Title or Position: CEO/ EXECUTIVE DIRECTOR
Credential:
Phone: 202-210-4962