Provider Demographics
NPI:1033724513
Name:S AND S PROPERTIES 3
Entity Type:Organization
Organization Name:S AND S PROPERTIES 3
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SVYATOSLAV
Authorized Official - Middle Name:
Authorized Official - Last Name:SHPARAGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-361-7545
Mailing Address - Street 1:25 HOOKS LN STE 200
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1619
Mailing Address - Country:US
Mailing Address - Phone:410-358-4415
Mailing Address - Fax:410-358-4417
Practice Address - Street 1:6122 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-3423
Practice Address - Country:US
Practice Address - Phone:410-358-4415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health