Healthcare Provider Details

I. General information

NPI: 1558533364
Provider Name (Legal Business Name): EASTER SEALS SERVING DC/MD/ VA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2008
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7138 WINDSOR BLVD
BALTIMORE MD
21244-2705
US

IV. Provider business mailing address

1420 SPRING ST
SILVER SPRING MD
20910-2701
US

V. Phone/Fax

Practice location:
  • Phone: 410-277-0940
  • Fax: 410-277-0943
Mailing address:
  • Phone: 301-920-9703
  • Fax: 301-920-9770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number21D0941126
License Number StateMD

VIII. Authorized Official

Name: MRS. ELIZABETH BARNES
Title or Position: VP OPERATIONS
Credential:
Phone: 301-920-9703