Healthcare Provider Details

I. General information

NPI: 1871709204
Provider Name (Legal Business Name): PACT: HELPING CHILDREN WITH SPECIAL NEEDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 TUDSBURY RD
BALTIMORE MD
21244
US

IV. Provider business mailing address

1741 ASHLAND AVE. PATIENT ACCOUNTING HELENA PORTER
BALTIMORE MD
21205
US

V. Phone/Fax

Practice location:
  • Phone: 410-298-7000
  • Fax: 410-448-7366
Mailing address:
  • Phone: 443-923-1878
  • Fax: 443-923-1985

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 Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. MIKE J NEUMAN
Title or Position: VICE PRESIDENT FINANCE
Credential:
Phone: 443-923-1810