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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1861924086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIME ORGANIZATION, INC.

Provider Business Mailing Address
First Line	:	2901 DRUID PARK DR STE A210
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-8137
Country	:	US
Telephone Number	:	410-227-9426
Fax Number	:

Provider Business Practice Location Address
First Line	:	2901 DRUID PARK DR STE A210
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-8137
Country	:	US
Telephone Number	:	410-227-9426
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	LAUREN HERRON
Credential	:	LCSW-C
Telephone Number	:	410-227-9426

Provider Enumeration Date	:	03/28/2017
Last Update Date	:	03/28/2017

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