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General NPI Number Information
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NPI Number | 1740009935
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Entity Type | Organization
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Legal Business Name | CHILDREN MAKING STRIDES OF MD LLC
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 2905 MARNAT RD A
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City | BALTIMORE
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State | MD
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Zip | 21209-2431
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Country | US
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Telephone | 347-930-7783
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Fax |
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Provider Business Mailing Address
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Address Line | 504 REYNOLDS AVE
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City | TOMS RIVER
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State | NJ
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Zip | 08755-1467
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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 | DIRECTOR
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Name | CHAIM FISKUS
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Credential |
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Telephone | 347-930-7783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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