| Jhh Costar Mobile Treatment | |
|
600 N Wolfe St Meyer 144d Baltimore MD 21287-0005 | |
| (410) 955-2004 | |
| (410) 955-5795 |
| Full Name | Jhh Costar Mobile Treatment |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 600 N Wolfe St, Baltimore, Maryland |
| Authorized Official Name and Position | Ronald J Werthman (VP FINANCE) |
| Authorized Official Contact | 4109556552 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jhh Costar Mobile Treatment Po Box 632051 Baltimore MD 21263-2051 Ph: (443) 997-0001 | Jhh Costar Mobile Treatment 600 N Wolfe St Meyer 144d Baltimore MD 21287-0005 Ph: (410) 955-2004 |
| NPI Number | 1154528065 |
|---|---|
| Provider Enumeration Date | 07/03/2007 |
| Last Update Date | 12/10/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154528065 | NPI | - | NPPES |
| 859650600 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 30034 (Maryland) | Primary |
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