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General NPI Number Information
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NPI Number | 1073748588
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Entity Type | Organization
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Legal Business Name | UMOJA HEALTH SYSTEM, LLC
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Dates
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Enumeration Date | 05/28/2009
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Last Update Date | 05/28/2009
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Provider Practice Location Address
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Address Line | 6564 REISTERSTOWN RD
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City | BALTIMORE
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State | MD
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Zip | 21215-2312
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Country | US
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Telephone | 443-204-1134
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Fax |
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Provider Business Mailing Address
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Address Line | 6564 REISTERSTOWN RD
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City | BALTIMORE
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State | MD
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Zip | 21215-2312
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Country | US
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Telephone | 443-204-1134
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | LAVON MAGRUDER
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Credential |
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Telephone | 443-204-1134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 12328
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License Number State | MD
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