Provider Demographics
NPI:1336799469
Name:A.W. HOLDINGS OF MARYLAND, INC.
Entity Type:Organization
Organization Name:A.W. HOLDINGS OF MARYLAND, INC.
Other - Org Name:BENCHMARK HUMAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARALEGAL
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-207-5730
Mailing Address - Street 1:8515 BLUFFTON RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46809-3022
Mailing Address - Country:US
Mailing Address - Phone:260-207-5730
Mailing Address - Fax:
Practice Address - Street 1:532 BALTIMORE BLVD STE 210
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6128
Practice Address - Country:US
Practice Address - Phone:443-426-2008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD300073700Medicaid