Youthtown Usa | |
12 2nd Ave Brooklyn MD 21225-2711 | |
(410) 609-0022 | |
(410) 609-2042 |
Full Name | Youthtown Usa |
---|---|
Speciality | Social Worker - Clinical |
Location | 12 2nd Ave, Brooklyn, Maryland |
Authorized Official Name and Position | Thomas Jose (PRESIDENT) |
Authorized Official Contact | 4106090022 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Youthtown Usa 12 2nd Ave Brooklyn MD 21225-2711 Ph: (410) 609-0022 | Youthtown Usa 12 2nd Ave Brooklyn MD 21225-2711 Ph: (410) 609-0022 |
NPI Number | 1093024028 |
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Provider Enumeration Date | 09/24/2010 |
Last Update Date | 09/24/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093024028 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 03868 (Maryland) | Primary |
1041C0700X | Social Worker - Clinical | 14520 (Maryland) | Secondary |
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