Provider Demographics
NPI:1790236016
Name:PROLOGUE, INC.
Entity Type:Organization
Organization Name:PROLOGUE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-653-6190
Mailing Address - Street 1:3 MILFORD MILL RD
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-6019
Mailing Address - Country:US
Mailing Address - Phone:410-653-6190
Mailing Address - Fax:410-653-6566
Practice Address - Street 1:3 MILFORD MILL RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-6019
Practice Address - Country:US
Practice Address - Phone:410-653-6190
Practice Address - Fax:410-653-6566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-21
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health