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NPI Code Detail

MEDICARE: TIME ORGANIZATION, INC

MEDICARE: TIME ORGANIZATION, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
2251S00000XCommunity/Behavioral Health AgencyMH-1146MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275877870
Entity Type Code : Organization
Provider Name (Legal Business Name) : TIME ORGANIZATION, INC
Provider Business Mailing Address
First Line : 2901 DRUID PARK DR
Second Line : SUITE A202
City : BALTIMORE
State : MD
Zip : 21215-8102
Country : US
Telephone Number : 410-225-0062
Fax Number : 410-225-0184
Provider Business Practice Location Address
First Line : 7310 RITCHIE HWY STE 100
Second Line :
City : GLEN BURNIE
State : MD
Zip : 21061-3170
Country : US
Telephone Number : 434-704-1082
Fax Number : 434-749-0221
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. LAMONT ANTHONY ELLIS
Credential : M.ED.
Telephone Number : 434-250-5784
Provider Enumeration Date : 11/20/2012
Last Update Date : 07/08/2019

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