Provider Demographics
NPI:1912553785
Name:WIN TEAM, LLC
Entity Type:Organization
Organization Name:WIN TEAM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFORD
Authorized Official - Middle Name:W
Authorized Official - Last Name:LAWS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:410-578-8003
Mailing Address - Street 1:2502 W NORTHERN PARKWAY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215
Mailing Address - Country:US
Mailing Address - Phone:410-578-8003
Mailing Address - Fax:410-578-0029
Practice Address - Street 1:4640 EDMONDSON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-1407
Practice Address - Country:US
Practice Address - Phone:410-578-8003
Practice Address - Fax:410-578-0029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health