Healthcare Provider Details
I. General information
NPI: 1508334459
Provider Name (Legal Business Name): HARFORD CRISIS CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/08/2018
Last Update Date: 06/16/2022
Certification Date: 06/16/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
802 BALTIMORE PIKE STE A
BEL AIR MD
21014-4212
US
IV. Provider business mailing address
520 UPPER CHESAPEAKE DR STE 405
BEL AIR MD
21014-4381
US
V. Phone/Fax
- Phone: 443-643-3464
- Fax: 443-643-3343
- Phone: 443-643-3464
- Fax: 443-643-3343
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARCUS
THOMAS AUGUSTUS
PRIOLO
Title or Position: CFO
Credential:
Phone: 443-643-3344