Provider Demographics
NPI:1043765068
Name:THE MARYLAND SALEM CHILDREN'S TRUST, INC.
Entity Type:Organization
Organization Name:THE MARYLAND SALEM CHILDREN'S TRUST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MECHEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-689-8176
Mailing Address - Street 1:605 SALEM DR
Mailing Address - Street 2:
Mailing Address - City:FROSTBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21532-6040
Mailing Address - Country:US
Mailing Address - Phone:301-689-8176
Mailing Address - Fax:301-689-1902
Practice Address - Street 1:605 SALEM DR
Practice Address - Street 2:
Practice Address - City:FROSTBURG
Practice Address - State:MD
Practice Address - Zip Code:21532-6040
Practice Address - Country:US
Practice Address - Phone:301-689-8176
Practice Address - Fax:301-689-1902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00246253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency