Provider Demographics
NPI:1912580218
Name:CLINICAL SOLUTIONS
Entity Type:Organization
Organization Name:CLINICAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICE/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:EDMUNDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-372-7628
Mailing Address - Street 1:4000 BLACKBURN LN STE 200
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-1104
Mailing Address - Country:US
Mailing Address - Phone:301-421-4241
Mailing Address - Fax:888-317-2075
Practice Address - Street 1:4000 BLACKBURN LN STE 150
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-6127
Practice Address - Country:US
Practice Address - Phone:301-421-4241
Practice Address - Fax:888-317-2075
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLINICAL SOLUTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-04
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)