Provider Demographics
NPI:1134628803
Name:SPECIALIZED HANDS LLC
Entity type:Organization
Organization Name:SPECIALIZED HANDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECT COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANEKA
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-542-7182
Mailing Address - Street 1:PO BOX 1763
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-1708
Mailing Address - Country:US
Mailing Address - Phone:240-542-7182
Mailing Address - Fax:
Practice Address - Street 1:3908 AMY LN # 2B
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-3610
Practice Address - Country:US
Practice Address - Phone:240-542-7182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty