| Our Place, Llc | |
|
4990 Mercantile Rd Unit 44723 Nottingham MD 21236-8572 | |
| (443) 819-0143 | |
| Not Available |
| Full Name | Our Place, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 4990 Mercantile Rd Unit 44723, Nottingham, Maryland |
| Authorized Official Name and Position | Matthew Piercey (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4438190143 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Our Place, Llc 4990 Mercantile Rd Unit 44723 Nottingham MD 21236-8572 Ph: (443) 819-0143 | Our Place, Llc 4990 Mercantile Rd Unit 44723 Nottingham MD 21236-8572 Ph: (443) 819-0143 |
| NPI Number | 1689418741 |
|---|---|
| Provider Enumeration Date | 06/24/2024 |
| Last Update Date | 06/24/2024 |
| Certification Date | 06/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689418741 | NPI | - | NPPES |
| 907666200 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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