Provider Demographics
NPI:1598025835
Name:RECLAIMING OUR CHILDREN AND COMMUNITY PROJECT, INC.
Entity Type:Organization
Organization Name:RECLAIMING OUR CHILDREN AND COMMUNITY PROJECT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANTE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-226-6866
Mailing Address - Street 1:PO BOX 29265
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-0565
Mailing Address - Country:US
Mailing Address - Phone:443-226-6866
Mailing Address - Fax:
Practice Address - Street 1:1900 E NORTHERN PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-2113
Practice Address - Country:US
Practice Address - Phone:443-759-9706
Practice Address - Fax:443-759-9707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMH-1074251S00000X
MDMH-1875251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD254803800Medicaid