Provider Demographics
NPI:1487005120
Name:MD CENTER FOR VETERANS EDUCATION & TRAINING, INC
Entity Type:Organization
Organization Name:MD CENTER FOR VETERANS EDUCATION & TRAINING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:KENDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-576-9626
Mailing Address - Street 1:301 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-4801
Mailing Address - Country:US
Mailing Address - Phone:410-576-9626
Mailing Address - Fax:
Practice Address - Street 1:301 N HIGH ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-4801
Practice Address - Country:US
Practice Address - Phone:410-576-9626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 324500000X, 347C00000X, 385H00000X
MDVA2142302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite Care