Healthcare Provider Details

I. General information

NPI: 1154532901
Provider Name (Legal Business Name): ANNE ARUNDEL COUNTY DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HAMMONDS LN
BALTIMORE MD
21225-3653
US

IV. Provider business mailing address

300 HAMMONDS LN
BALTIMORE MD
21225-3653
US

V. Phone/Fax

Practice location:
  • Phone: 410-222-6622
  • Fax:
Mailing address:
  • Phone: 410-222-6622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number05637
License Number StateMD

VIII. Authorized Official

Name: MRS. LISA TULL ELDRIDGE
Title or Position: SOCIAL WORKER ADVANCED
Credential: LCSW-C
Phone: 410-222-6622