Provider Demographics
NPI:1952034670
Name:INNER HARBOR PARTNERS, LLC
Entity Type:Organization
Organization Name:INNER HARBOR PARTNERS, LLC
Other - Org Name:BY YOUR SIDE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVON
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-621-7326
Mailing Address - Street 1:405 FREDERICK RD STE 256
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4666
Mailing Address - Country:US
Mailing Address - Phone:410-600-3467
Mailing Address - Fax:
Practice Address - Street 1:405 FREDERICK RD STE 256
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4666
Practice Address - Country:US
Practice Address - Phone:410-600-3467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INNER HARBOR PARTNERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-09
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health