Provider Demographics
NPI:1144680109
Name:CHILDREN'S CHOICE OF MARYLAND, INC
Entity type:Organization
Organization Name:CHILDREN'S CHOICE OF MARYLAND, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESPITE PROJECT SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-880-3887
Mailing Address - Street 1:PO BOX 535
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21619-0535
Mailing Address - Country:US
Mailing Address - Phone:410-643-6342
Mailing Address - Fax:
Practice Address - Street 1:1563 POSTAL RD STE 3B
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:MD
Practice Address - Zip Code:21619-2318
Practice Address - Country:US
Practice Address - Phone:410-643-9290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-03
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care