Organization Name: | RUTH A. GOLDBLOOM, P.A. |
NPI Number: | 1275713356 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RUTH ALICE GOLDBLOOM (OWNERN& CHIEF CLINICIAN) |
Mailing Address: | 12590 National Pike Suite 2 Grantsville |
State: | MD US |
Postal Code: | 215363310 |
Phone Number: | 3018953388 |
Fax Number: | 3018953399 |
NPI Enumeration Date: | 11/06/2007 |
NPI Last Update Date: | 11/06/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0850X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Mental Health |
Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |