MEDICARE: WINDSOR MANOR

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	102L00000X	Psychoanalyst
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
3	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
4	364SP0812X	Community Psychiatric/Mental Health Clinical Nurse Specialist

General Provider Information

NPI Number	:	1568311660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINDSOR MANOR

Provider Business Mailing Address
First Line	:	3333 WINDSOR AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21216-2617
Country	:	US
Telephone Number	:	443-449-5505
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 WINDSOR AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21216-2617
Country	:	US
Telephone Number	:	443-449-5505
Fax Number	:

Authorized Official
Title or Position	:	CONSULTANT
Name	:	ALFRED AJISHE
Credential	:
Telephone Number	:	202-460-7577

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	01/23/2026

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Directions to “WINDSOR MANOR ” Practice Location

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