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General NPI Number Information
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NPI Number | 1730402637
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR LIFE ENRICHMENT
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Dates
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Enumeration Date | 03/05/2010
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Last Update Date | 03/08/2010
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Provider Practice Location Address
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Address Line | 5600 LOCH RAVEN BLVD
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City | BALTIMORE
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State | MD
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Zip | 21239-2903
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Country | US
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Telephone | 443-444-3848
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Fax |
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Provider Business Mailing Address
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Address Line | 7852 16TH ST NW
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City | WASHINGTON
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State | DC
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Zip | 20012-1200
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Country | US
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Telephone | 202-291-5009
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES SAVAGE JR.
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Credential | PH.D.
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Telephone | 202-291-5009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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