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General NPI Number Information
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NPI Number | 1083912406
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Entity Type | Organization
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Legal Business Name | LEVELS ADULT DAY CARE
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Dates
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Enumeration Date | 03/09/2011
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Last Update Date | 02/13/2017
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Provider Practice Location Address
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Address Line | 210 W. 28TH ST.
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City | BALTIMORE
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State | MD
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Zip | 21211
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Country | US
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Telephone | 410-779-7487
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Fax | 866-379-4645
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Provider Business Mailing Address
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Address Line | 210 W. 28TH ST.
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City | BALTIMORE
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State | MD
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Zip | 21211
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Country | US
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Telephone | 410-779-7487
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Fax | 866-379-4645
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Authorized Official
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Title or Position | MANAGER
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Name | MR. ISSAC C EVANS
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Credential | NA
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Telephone | 443-453-7746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 261QA0600
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License Number State | MD
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