Healthcare Provider Details

I. General information

NPI: 1407916844
Provider Name (Legal Business Name): BUILDING COMMUNITIES TODAY FOR TOMORROW INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 01/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 DRUID PARK DR A207
BALTIMORE MD
21215-8102
US

IV. Provider business mailing address

PO BOX 7547
BALTIMORE MD
21207
US

V. Phone/Fax

Practice location:
  • Phone: 410-467-6600
  • Fax: 410-225-9110
Mailing address:
  • Phone: 410-467-6600
  • Fax: 410-225-9110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number765320400
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number400975400
License Number StateMD

VIII. Authorized Official

Name: MR. CEDRIC LEMAR TUCKER
Title or Position: PRESIDENT/COO
Credential:
Phone: 410-467-6600