| Leading By Example Llc. | |
|
5026 Campbell Blvd Suite 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 | Johnnie Fielding (PROGRAM DIRECTOR) |
| Authorized Official Contact | 4107802692 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leading By Example Llc. 5026 Campbell Blvd Suite H Nottingham MD 21236-4966 Ph: (410) 780-2692 | Leading By Example Llc. 5026 Campbell Blvd Suite H Nottingham MD 21236-4966 Ph: (410) 780-2692 |
| NPI Number | 1760610596 |
|---|---|
| Provider Enumeration Date | 07/01/2009 |
| Last Update Date | 08/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760610596 | NPI | - | NPPES |
| 417333300 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (Maryland) | Primary |
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