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3512 Sandpiper Ct Edgewood MD 21040-3736 | |
| (443) 866-7504 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3512 Sandpiper Ct, Edgewood, Maryland |
| Authorized Official Name and Position | Quinton Myers (CEO) |
| Authorized Official Contact | 4438667504 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3512 Sandpiper Ct Edgewood MD 21040-3736 Ph: (443) 866-7504 | 3512 Sandpiper Ct Edgewood MD 21040-3736 Ph: (443) 866-7504 |
| NPI Number | 1386181311 |
|---|---|
| Provider Enumeration Date | 01/29/2017 |
| Last Update Date | 01/29/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386181311 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 5000000000741693 (Maryland) | Primary |
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