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General NPI Number Information
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NPI Number | 1275202715
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Entity Type | Organization
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Legal Business Name | BOARD OF CARROLL COUNTY COMMISSIONERS
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Dates
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Enumeration Date | 09/08/2021
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 125 STONER AVE
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City | WESTMINSTER
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State | MD
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Zip | 21157-5451
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Country | US
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Telephone | 410-386-3809
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Fax | 410-840-0436
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Provider Business Mailing Address
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Address Line | 125 STONER AVE
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City | WESTMINSTER
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State | MD
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Zip | 21157-5451
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Country | US
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Telephone | 410-386-3809
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Fax | 410-840-0436
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Authorized Official
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Title or Position | COMMUNITY SERVICES SUPERVISOR
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Name | RICHARD M OTTONE
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Credential |
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Telephone | 410-386-3800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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