Healthcare Provider Details

I. General information

NPI: 1851907141
Provider Name (Legal Business Name): TIME ORGANIZATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2020
Last Update Date: 09/06/2023
Certification Date: 09/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4538 EDMONDSON AVE
BALTIMORE MD
21229-1506
US

IV. Provider business mailing address

300 E LOMBARD ST STE 1700
BALTIMORE MD
21202-3243
US

V. Phone/Fax

Practice location:
  • Phone: 443-872-2230
  • Fax:
Mailing address:
  • Phone: 410-227-9426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: LAUREN HERRON
Title or Position: VICE PRESIDENT
Credential:
Phone: 410-227-9426