Provider Demographics
NPI:1376775627
Name:BALTIMORE COUNTY HEALTH DEPT
Entity Type:Organization
Organization Name:BALTIMORE COUNTY HEALTH DEPT
Other - Org Name:DEPT OF SUBTANCE ABUSE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-887-3828
Mailing Address - Street 1:8600 LASALLE RD
Mailing Address - Street 2:SUITE 504
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-2001
Mailing Address - Country:US
Mailing Address - Phone:410-887-3670
Mailing Address - Fax:410-887-3675
Practice Address - Street 1:8600 LASALLE RD
Practice Address - Street 2:SUITE 504
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21286-2001
Practice Address - Country:US
Practice Address - Phone:410-887-3670
Practice Address - Fax:410-887-3675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSC1241302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization