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General NPI Number Information
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NPI Number | 1114239555
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Entity Type | Organization
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Legal Business Name | CSU HELENE FULD SON SBHC/COMM CTR @ ST FRAN ACAD
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Dates
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Enumeration Date | 07/13/2010
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Last Update Date | 07/13/2010
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Provider Practice Location Address
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Address Line | 501 E CHASE ST
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City | BALTIMORE
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State | MD
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Zip | 21202-4206
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Country | US
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Telephone | 410-528-8747
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Fax | 410-528-8748
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Provider Business Mailing Address
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Address Line | 501 E CHASE ST
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City | BALTIMORE
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State | MD
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Zip | 21202-4206
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Country | US
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Telephone | 410-528-8747
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Fax | 410-528-8748
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Authorized Official
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Title or Position | DEAN
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Name | DR. MARCELLA A COPES
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Credential | PHD
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Telephone | 410-951-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 21D1004200
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License Number State | MD
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