Provider Demographics
NPI:1275202715
Name:BOARD OF CARROLL COUNTY COMMISSIONERS
Entity Type:Organization
Organization Name:BOARD OF CARROLL COUNTY COMMISSIONERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMUNITY SERVICES SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:OTTONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-386-3800
Mailing Address - Street 1:125 STONER AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5451
Mailing Address - Country:US
Mailing Address - Phone:410-386-3809
Mailing Address - Fax:410-840-0436
Practice Address - Street 1:125 STONER AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5451
Practice Address - Country:US
Practice Address - Phone:410-386-3809
Practice Address - Fax:410-840-0436
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOARD OF CARROLL COUNTY COMMISSIONERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Multi-Specialty