| Leading By Example Llc | |
|
5026 Campbell Blvd H Nottingham MD 21236-4966 | |
| (410) 780-2692 | |
| (410) 780-2694 |
| Full Name | Leading By Example Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5026 Campbell Blvd, Nottingham, Maryland |
| Authorized Official Name and Position | Mary Rimi (PROGRAM DEVELOPMENT MANAGER) |
| Authorized Official Contact | 4107802692 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leading By Example Llc 5026 Campbell Blvd H Nottingham MD 21236-4966 Ph: (410) 780-2692 | Leading By Example Llc 5026 Campbell Blvd H Nottingham MD 21236-4966 Ph: (410) 780-2692 |
| NPI Number | 1720512353 |
|---|---|
| Provider Enumeration Date | 04/20/2017 |
| Last Update Date | 04/20/2017 |
| Medicare PECOS PAC ID | 4880019645 |
|---|---|
| Medicare Enrollment ID | O20200811000591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720512353 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Quinton G Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528411725 PECOS PAC ID: 4385922699 Enrollment ID: I20161020001284 |
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