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General NPI Number Information
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NPI Number | 1245786425
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Entity Type | Organization
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Legal Business Name | THE CHILDREN'S CHOICE OF MARYLAND, INC
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Dates
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Enumeration Date | 08/29/2016
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Last Update Date | 08/29/2016
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Provider Practice Location Address
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Address Line | 1563 POSTAL RD SUITE 3B
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City | CHESTER
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State | MD
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Zip | 21619-2299
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Country | US
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Telephone | 410-643-6342
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 535
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City | CHESTER
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State | MD
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Zip | 21619-0535
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RESPITE PROJECT SUPERVISOR
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Name | ANDREW MCCAULEY
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Credential |
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Telephone | 410-643-9290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 1787
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License Number State | MD
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