Provider Demographics
NPI:1538469259
Name:HARFORD COUNTY INFANTS &TODDLERS PROGRAM
Entity Type:Organization
Organization Name:HARFORD COUNTY INFANTS &TODDLERS PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN-MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPAKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-588-5246
Mailing Address - Street 1:102 S HICKORY AVE
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3731
Mailing Address - Country:US
Mailing Address - Phone:410-838-7300
Mailing Address - Fax:410-638-4313
Practice Address - Street 1:102 S HICKORY AVE
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3731
Practice Address - Country:US
Practice Address - Phone:410-838-7300
Practice Address - Fax:410-638-4313
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARFORD COUNTY PUBLIC SCHOOLS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD541598500Medicaid