Provider Demographics
NPI:1821759671
Name:CORE FAMILY SERVICES, LLC
Entity Type:Organization
Organization Name:CORE FAMILY SERVICES, LLC
Other - Org Name:CORE FAMILY SERVICE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP-PMH
Authorized Official - Phone:443-801-2233
Mailing Address - Street 1:1800 N CHARLES ST STE 406
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5909
Mailing Address - Country:US
Mailing Address - Phone:443-801-2233
Mailing Address - Fax:443-835-3875
Practice Address - Street 1:1800 N CHARLES ST STE 406
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5909
Practice Address - Country:US
Practice Address - Phone:443-801-2233
Practice Address - Fax:443-835-3875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-04
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)