Healthcare Provider Details

I. General information

NPI: 1053077818
Provider Name (Legal Business Name): THE TIME ORGANIZATION GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2021
Last Update Date: 06/13/2022
Certification Date: 06/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2517 N CHARLES ST
BALTIMORE MD
21218-4602
US

IV. Provider business mailing address

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

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: MS. LAUREN HERRON
Title or Position: VICE PRESIDENT
Credential: LCSW-C
Phone: 410-227-9426