Provider Demographics
NPI:1326625559
Name:WESTMINSTER RESCUE MISSION
Entity Type:Organization
Organization Name:WESTMINSTER RESCUE MISSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LYNNE (MARTIN)
Authorized Official - Last Name:HALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-848-2222
Mailing Address - Street 1:658 LUCABAUGH MILL RD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157
Mailing Address - Country:US
Mailing Address - Phone:410-848-2222
Mailing Address - Fax:
Practice Address - Street 1:658 LUCABAUGH MILL RD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157
Practice Address - Country:US
Practice Address - Phone:410-848-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WESTMINSTER RESCUE MISSION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD725011800Medicaid