Healthcare Provider Details
I. General information
NPI: 1467878462
Provider Name (Legal Business Name): KEY POINT HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2014
Last Update Date: 03/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1001 CROMWELL BRIDGE RD SUITE 212
TOWSON MD
21286-3300
US
IV. Provider business mailing address
135 N PARKE ST
ABERDEEN MD
21001-2428
US
V. Phone/Fax
- Phone: 410-337-5523
- Fax: 410-337-5576
- Phone: 443-625-1588
- Fax: 443-625-1595
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 4607 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | 4607 |
| License Number State | MD |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 320800000X |
| Taxonomy | Mental Illness Community Based Residential Treatment Facility |
| License Number | 4607 |
| License Number State | MD |
VIII. Authorized Official
Name: MR.
KARL
D
WEBER
Title or Position: CEO
Credential: PHD
Phone: 443-625-1588