Provider Demographics
NPI:1033573050
Name:HEALTH CARE FOR THE HOMELESS, INC.
Entity Type:Organization
Organization Name:HEALTH CARE FOR THE HOMELESS, INC.
Other - Org Name:HEALTH CARE FOR THE HOMELESS WEST BALTIMORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDAMOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-837-5533
Mailing Address - Street 1:421 FALLSWAY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-4800
Mailing Address - Country:US
Mailing Address - Phone:410-837-5533
Mailing Address - Fax:410-837-8020
Practice Address - Street 1:2000 W BALTIMORE ST
Practice Address - Street 2:SUITE 247
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-1558
Practice Address - Country:US
Practice Address - Phone:443-703-1400
Practice Address - Fax:443-863-6661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-06
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1223G0001X
261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD383841200Medicaid
MD383841200Medicaid