Provider Demographics
NPI:1659728517
Name:BROWNSTONE PROJECT IN MD
Entity Type:Organization
Organization Name:BROWNSTONE PROJECT IN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BARON
Authorized Official - Middle Name:
Authorized Official - Last Name:COKER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:404-437-3700
Mailing Address - Street 1:1400 VETERANS MEMORIAL HWY SE STE 130
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-2947
Mailing Address - Country:US
Mailing Address - Phone:240-297-6228
Mailing Address - Fax:240-297-6292
Practice Address - Street 1:6201 GREENBELT RD STE M6
Practice Address - Street 2:
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740
Practice Address - Country:US
Practice Address - Phone:240-297-6228
Practice Address - Fax:240-297-6292
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:C&C MANAGEMENT GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-20
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health