| Broad Place, Inc | |
|
902 Washington Rd Ste G Westminster MD 21157-5832 | |
| (240) 360-3693 | |
| (443) 405-7237 |
| Full Name | Broad Place, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 902 Washington Rd Ste G, Westminster, Maryland |
| Authorized Official Name and Position | Abimbola Runsewe (CEO/OWNER) |
| Authorized Official Contact | 2403603693 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broad Place, Inc 902 Washington Rd Ste G Westminster MD 21157-5832 Ph: (240) 360-3693 | Broad Place, Inc 902 Washington Rd Ste G Westminster MD 21157-5832 Ph: (240) 360-3693 |
| NPI Number | 1043043201 |
|---|---|
| Provider Enumeration Date | 08/22/2024 |
| Last Update Date | 08/22/2024 |
| Certification Date | 08/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043043201 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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