| Madonna Healthcare Services Inc | |
|
2300 Garrison Blvd Ste 230 Baltimore MD 21216-2377 | |
| (410) 233-4039 | |
| (410) 233-4052 |
| Full Name | Madonna Healthcare Services Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2300 Garrison Blvd Ste 230, Baltimore, Maryland |
| Authorized Official Name and Position | Nkem Egudia (CEO/PROGRAM DIRECTOR) |
| Authorized Official Contact | 4102334039 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Madonna Healthcare Services Inc 2300 Garrison Blvd Ste 230 Baltimore MD 21216-2377 Ph: (410) 233-4039 | Madonna Healthcare Services Inc 2300 Garrison Blvd Ste 230 Baltimore MD 21216-2377 Ph: (410) 233-4039 |
| NPI Number | 1164725891 |
|---|---|
| Provider Enumeration Date | 12/20/2010 |
| Last Update Date | 05/25/2021 |
| Certification Date | 05/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164725891 | NPI | - | NPPES |
| 420235000 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 4793 (Maryland) | Primary |
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