Healthcare Provider Details

I. General information

NPI: 1811608193
Provider Name (Legal Business Name): WILCOME HUMAN SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2022
Last Update Date: 12/08/2022
Certification Date: 12/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8707 HARFORD RD STE B
BALTIMORE MD
21234-4661
US

IV. Provider business mailing address

335 N MAIN ST
YORK PA
17403-9617
US

V. Phone/Fax

Practice location:
  • Phone: 844-945-2663
  • Fax:
Mailing address:
  • Phone: 844-945-2663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: LATOYA FRAZIER
Title or Position: FOUNDER/BOD
Credential:
Phone: 844-945-2663