Provider Demographics
NPI:1962027631
Name:CHILD AND ADULT PSYCHIATRY CHARITO QUINTERO-HOWARD, MD, LLC
Entity Type:Organization
Organization Name:CHILD AND ADULT PSYCHIATRY CHARITO QUINTERO-HOWARD, MD, LLC
Other - Org Name:CHILD AND ADULT PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARITO
Authorized Official - Middle Name:V
Authorized Official - Last Name:QUINTERO-HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-337-0007
Mailing Address - Street 1:13919 GREEN BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:MD
Mailing Address - Zip Code:21131-1315
Mailing Address - Country:US
Mailing Address - Phone:410-402-4284
Mailing Address - Fax:
Practice Address - Street 1:630 TOWNE CENTER DR
Practice Address - Street 2:
Practice Address - City:JOPPA
Practice Address - State:MD
Practice Address - Zip Code:21085-4440
Practice Address - Country:US
Practice Address - Phone:410-510-7099
Practice Address - Fax:410-510-7955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-09
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)