Provider Demographics
NPI:1679914238
Name:TOTAL HEALTH CARE
Entity Type:Organization
Organization Name:TOTAL HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:BERIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CANDELARIO
Authorized Official - Suffix:
Authorized Official - Credentials:LGSW-C
Authorized Official - Phone:410-383-7760
Mailing Address - Street 1:2401 LIBERTY HEIGHTS AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-8019
Mailing Address - Country:US
Mailing Address - Phone:410-383-7760
Mailing Address - Fax:
Practice Address - Street 1:2401 LIBERTY HEIGHTS AVE STE 111
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-8019
Practice Address - Country:US
Practice Address - Phone:410-383-7760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG12677302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization