| Grassroots Crisis Intervention Center, Inc. | |
|
8990 Old Annapolis Rd Ste A Columbia MD 21045-2182 | |
| (410) 531-6677 | |
| Not Available |
| Full Name | Grassroots Crisis Intervention Center, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 8990 Old Annapolis Rd Ste A, Columbia, Maryland |
| Authorized Official Name and Position | Mariana Izraelson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4105316006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grassroots Crisis Intervention Center, Inc. 6700 Freetown Rd Columbia MD 21044-4137 Ph: (410) 531-6006 | Grassroots Crisis Intervention Center, Inc. 8990 Old Annapolis Rd Ste A Columbia MD 21045-2182 Ph: (410) 531-6677 |
| NPI Number | 1003657040 |
|---|---|
| Provider Enumeration Date | 06/04/2024 |
| Last Update Date | 06/04/2024 |
| Certification Date | 06/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003657040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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