Organization Name: | ST. JOHN THE BAPTIST ADULT MED. DAYCARE |
NPI Number: | 1720382708 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH E. DEVEDOSS (PRESIDENT) |
Mailing Address: | 10947 Golden West Dr Ste 200 Hunt Valley |
State: | MD US |
Postal Code: | 210311312 |
Phone Number: | 4103291444 |
Fax Number: | 4103291533 |
NPI Enumeration Date: | 01/05/2011 |
NPI Last Update Date: | 01/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA0600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Day Care |
Taxonomy Definition: |