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General NPI Number Information
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NPI Number | 1720382708
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Entity Type | Organization
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Legal Business Name | ST. JOHN THE BAPTIST ADULT MED. DAYCARE
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Dates
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Enumeration Date | 01/05/2011
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Last Update Date | 01/05/2011
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Provider Practice Location Address
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Address Line | 10947 GOLDEN WEST DR STE 200
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City | HUNT VALLEY
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State | MD
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Zip | 21031-1312
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Country | US
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Telephone | 410-329-1444
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Fax | 410-329-1533
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Provider Business Mailing Address
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Address Line | 10947 GOLDEN WEST DR STE 200
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City | HUNT VALLEY
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State | MD
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Zip | 21031-1312
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Country | US
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Telephone | 410-329-1444
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Fax | 410-329-1533
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH E. DEVEDOSS
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Credential |
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Telephone | 410-298-9800
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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 |
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License Number State | MD
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