Provider Demographics
NPI:1629553037
Name:WIN TEAM, LLC
Entity Type:Organization
Organization Name:WIN TEAM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFORD
Authorized Official - Middle Name:W
Authorized Official - Last Name:LAWS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:410-578-8003
Mailing Address - Street 1:4715 WARDS CHAPEL ROAD
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117
Mailing Address - Country:US
Mailing Address - Phone:410-578-8003
Mailing Address - Fax:
Practice Address - Street 1:7 PLEASANT VIEW CHRURCH ROAD
Practice Address - Street 2:
Practice Address - City:PORT DEPOSIT
Practice Address - State:MD
Practice Address - Zip Code:21904
Practice Address - Country:US
Practice Address - Phone:443-643-7161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health