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General NPI Number Information
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NPI Number | 1790236016
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Entity Type | Organization
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Legal Business Name | PROLOGUE, INC.
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Dates
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Enumeration Date | 10/21/2016
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Last Update Date | 10/21/2016
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Provider Practice Location Address
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Address Line | 3 MILFORD MILL RD
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City | PIKESVILLE
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State | MD
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Zip | 21208-6019
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Country | US
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Telephone | 410-653-6190
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Fax | 410-653-6566
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Provider Business Mailing Address
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Address Line | 3 MILFORD MILL RD
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City | PIKESVILLE
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State | MD
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Zip | 21208-6019
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Country | US
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Telephone | 410-653-6190
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Fax | 410-653-6566
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | SENDY ROMMEL
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Credential |
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Telephone | 410-653-6190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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