Provider Demographics
NPI:1134967375
Name:MY FATHER'S HEART, INC.
Entity type:Organization
Organization Name:MY FATHER'S HEART, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:WAINWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:410-245-1644
Mailing Address - Street 1:3112 E BIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-3920
Mailing Address - Country:US
Mailing Address - Phone:410-245-1644
Mailing Address - Fax:
Practice Address - Street 1:4017 BONNER RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-1207
Practice Address - Country:US
Practice Address - Phone:410-245-1644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health