Provider Demographics
NPI:1518619550
Name:BALTIMORE ADULT MEDICAL DAY CENTER, LLC
Entity Type:Organization
Organization Name:BALTIMORE ADULT MEDICAL DAY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAUNESE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-865-1129
Mailing Address - Street 1:800 S CATON AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-4210
Mailing Address - Country:US
Mailing Address - Phone:443-865-1129
Mailing Address - Fax:443-451-8124
Practice Address - Street 1:800 S CATON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-4210
Practice Address - Country:US
Practice Address - Phone:443-865-1129
Practice Address - Fax:443-451-8124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care