Provider Demographics
NPI:1801371752
Name:KEY POINT HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:KEY POINT HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:NULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-625-1588
Mailing Address - Street 1:135 N PARKE ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001-2428
Mailing Address - Country:US
Mailing Address - Phone:443-625-1590
Mailing Address - Fax:443-625-1595
Practice Address - Street 1:516 N ROLLING RD STE 104
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4141
Practice Address - Country:US
Practice Address - Phone:443-625-1587
Practice Address - Fax:443-625-1595
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KEY POINT HEALTH SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDBH001099OtherBEHAVIORAL HEALTH ADMINISTRATION LICENSE NUMBER