Provider Demographics
NPI:1750829362
Name:MARYLAND MEDICAL DAY SERVICES, LLC
Entity Type:Organization
Organization Name:MARYLAND MEDICAL DAY SERVICES, LLC
Other - Org Name:N/A
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAUNESE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-468-0310
Mailing Address - Street 1:2605 BANISTER RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-6505
Mailing Address - Country:US
Mailing Address - Phone:443-865-1129
Mailing Address - Fax:
Practice Address - Street 1:2605 BANISTER RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-6505
Practice Address - Country:US
Practice Address - Phone:443-865-1129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care