Healthcare Provider Details

I. General information

NPI: 1871717264
Provider Name (Legal Business Name): HUMANIM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6355 WOODSIDE CT
COLUMBIA MD
21046-1071
US

IV. Provider business mailing address

6355 WOODSIDE CT
COLUMBIA MD
21046-1071
US

V. Phone/Fax

Practice location:
  • Phone: 410-381-7171
  • Fax: 410-381-5137
Mailing address:
  • Phone: 410-381-7171
  • Fax: 410-381-5137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: GALE BRITTON
Title or Position: DIR. OF BILLING
Credential:
Phone: 410-381-7471