Provider Demographics
NPI:1417331992
Name:HEALTH CARE FOR THE HOMELESS, INC.
Entity Type:Organization
Organization Name:HEALTH CARE FOR THE HOMELESS, INC.
Other - Org Name:HEALTH CARE FOR THE HOMELESS HARTFORD COUNTY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDAMOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-837-5533
Mailing Address - Street 1:421 FALLSWAY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202
Mailing Address - Country:US
Mailing Address - Phone:410-837-5533
Mailing Address - Fax:410-837-8020
Practice Address - Street 1:1 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014
Practice Address - Country:US
Practice Address - Phone:410-638-3060
Practice Address - Fax:410-837-8020
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH CARE FOR THE HOMELESS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)