| Vlasova Llc | |
|
12023 Eastern Ave Baltimore MD 21220-1301 | |
| (443) 676-1982 | |
| (443) 451-8541 |
| Full Name | Vlasova Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 12023 Eastern Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Nataliya Vlasova (OWNER) |
| Authorized Official Contact | 4436761982 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vlasova Llc 12023 Eastern Ave Baltimore MD 21220-1301 Ph: (443) 676-1982 | Vlasova Llc 12023 Eastern Ave Baltimore MD 21220-1301 Ph: (443) 676-1982 |
| NPI Number | 1619519113 |
|---|---|
| Provider Enumeration Date | 10/16/2019 |
| Last Update Date | 10/16/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619519113 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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