| Forbush School At Edgar Allen Poe | |
|
2001 Shadyside Ave Suitland MD 20746-4805 | |
| (301) 702-2130 | |
| (301) 702-4461 |
| Full Name | Forbush School At Edgar Allen Poe |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 2001 Shadyside Ave, Suitland, Maryland |
| Authorized Official Name and Position | Bonnie B. Katz (VP CORPORATE BUSINESS DEVELOPMENT) |
| Authorized Official Contact | 4109383150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Forbush School At Edgar Allen Poe 6501 N Charles St Baltimore MD 21204-6819 Ph: (410) 938-3000 | Forbush School At Edgar Allen Poe 2001 Shadyside Ave Suitland MD 20746-4805 Ph: (301) 702-2130 |
| NPI Number | 1922152578 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 01/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922152578 | NPI | - | NPPES |
| 3960 | Other | MD | SCHOOL LICENSE NUMBER |
| 411238500 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 3960 (Maryland) | Primary |
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