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General NPI Number Information
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NPI Number | 1750942355
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Entity Type | Organization
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Legal Business Name | BALTIMORE AREA COMMUNITY HEALTH SERVICES LLC
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Dates
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Enumeration Date | 06/25/2019
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Last Update Date | 06/25/2019
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Provider Practice Location Address
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Address Line | 517 E OLDTOWN RD # 1
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City | CUMBERLAND
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State | MD
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Zip | 21502-3687
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Country | US
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Telephone | 301-777-9600
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Fax | 410-697-6055
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Provider Business Mailing Address
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Address Line | 4128 HAYWARD AVE STE G
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City | BALTIMORE
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State | MD
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Zip | 21215-4340
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Country | US
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Telephone | 443-844-4770
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JUDITH NICOLE SMITH-DOWNING
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Credential |
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Telephone | 410-994-6491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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License Number State |
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