MEDICARE: THE CHILDREN'S GUILD, 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
1	251S00000X	Community/Behavioral Health Agency		MD

Other Identifiers

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

General Provider Information

NPI Number	:	1306023817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CHILDREN'S GUILD, INC.

Provider Business Mailing Address
First Line	:	6802 MCCLEAN BLVD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21234-7260
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6802 MCCLEAN BLVD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21234-7260
Country	:	US
Telephone Number	:	410-444-3800
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	STEVE BALDWIN
Credential	:
Telephone Number	:	410-444-3800

Provider Enumeration Date	:	01/28/2008
Last Update Date	:	01/28/2008

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