| Bostic Project | |
|
1528 Northgate Rd Baltimore MD 21218-1618 | |
| (443) 267-8421 | |
| Not Available |
| Full Name | Bostic Project |
|---|---|
| Speciality | Social Worker |
| Location | 1528 Northgate Rd, Baltimore, Maryland |
| Authorized Official Name and Position | Danielle Bostic (CEO) |
| Authorized Official Contact | 4437695434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bostic Project 1400 W Lombard St # 1054 Baltimore MD 21223-3134 Ph: (443) 267-8421 | Bostic Project 1528 Northgate Rd Baltimore MD 21218-1618 Ph: (443) 267-8421 |
| NPI Number | 1861143836 |
|---|---|
| Provider Enumeration Date | 01/12/2022 |
| Last Update Date | 03/17/2022 |
| Certification Date | 03/17/2022 |
| Medicare PECOS PAC ID | 1153716535 |
|---|---|
| Medicare Enrollment ID | O20220322001167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861143836 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 385H00000X | Respite Care | (* (Not Available)) | Secondary |
| Provider Name | Danielle Bostic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255900643 PECOS PAC ID: 9537566138 Enrollment ID: I20210924000414 |
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