Organization Name: | MSBC FIVE STAR PROGRAM INC |
NPI Number: | 1427256379 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHARISSE KIANNA MERCER (OFFICE MANGER) |
Mailing Address: | 6665 Security Blvd Woodlawn |
State: | MD US |
Postal Code: | 212074018 |
Phone Number: | 4102657291 |
Fax Number: | 4102657294 |
NPI Enumeration Date: | 07/03/2007 |
NPI Last Update Date: | 02/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |