Provider Demographics
NPI:1699196279
Name:STALWART CORPORATION
Entity Type:Organization
Organization Name:STALWART CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FELECIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-256-5255
Mailing Address - Street 1:218 E LEXINGTON ST
Mailing Address - Street 2:STE 500A
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-3532
Mailing Address - Country:US
Mailing Address - Phone:216-256-5255
Mailing Address - Fax:
Practice Address - Street 1:218 E LEXINGTON ST
Practice Address - Street 2:STE 500A
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-3532
Practice Address - Country:US
Practice Address - Phone:216-256-5255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities