Healthcare Provider Details

I. General information

NPI: 1679221873
Provider Name (Legal Business Name): MAYOR AND CITY COUNCIL OF BALTIMORE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2022
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E FAYETTE ST RM 233
BALTIMORE MD
21202-4721
US

IV. Provider business mailing address

1001 E FAYETTE ST
BALTIMORE MD
21202-4715
US

V. Phone/Fax

Practice location:
  • Phone: 410-396-9404
  • Fax:
Mailing address:
  • Phone: 410-396-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: REGINA GIBBS
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 410-396-8000