Provider Demographics
NPI:1114707650
Name:SENSE OF SOLACE LLC
Entity Type:Organization
Organization Name:SENSE OF SOLACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LILLIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-713-5746
Mailing Address - Street 1:PO BOX 985
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-0985
Mailing Address - Country:US
Mailing Address - Phone:667-770-6549
Mailing Address - Fax:866-949-4549
Practice Address - Street 1:1311 S MAIN ST STE 302C
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-5464
Practice Address - Country:US
Practice Address - Phone:667-770-6549
Practice Address - Fax:866-949-4549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-03
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health