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General NPI Number Information
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NPI Number | 1942662846
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Entity Type | Organization
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Legal Business Name | BAY AREA CENTER FOR INDEPENDENT LIVING, INC.
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 03/22/2016
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Provider Practice Location Address
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Address Line | 909 PROGRESS CIR
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City | SALISBURY
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State | MD
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Zip | 21804-2323
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Country | US
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Telephone | 443-614-8777
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Fax |
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Provider Business Mailing Address
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Address Line | 909 PROGRESS CIR PO BOX 1489
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City | SALISBURY
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State | MD
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Zip | 21804-2323
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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 | DEPUTY DIRECTOR
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Name | JEFFREY BYRNE
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Credential | LCSW-C
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Telephone | 443-614-8777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 07049
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License Number State | MD
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