Healthcare Provider Details

I. General information

NPI: 1215806484
Provider Name (Legal Business Name): QUEENS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 E CHASE ST STE 1125
BALTIMORE MD
21202-2565
US

IV. Provider business mailing address

1 E CHASE ST STE 1125
BALTIMORE MD
21202-2565
US

V. Phone/Fax

Practice location:
  • Phone: 443-570-5334
  • Fax:
Mailing address:
  • Phone: 443-570-5334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MILDRED QUEEN
Title or Position: CEO
Credential:
Phone: 443-703-8838