Provider Demographics
NPI:1457984700
Name:THE CHILDREN'S GUILD, INC
Entity Type:Organization
Organization Name:THE CHILDREN'S GUILD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE AND CREDENTIALING COORDI
Authorized Official - Prefix:
Authorized Official - First Name:RAELENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MENESES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:410-444-3804
Mailing Address - Street 1:6802 MCCLEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-7200
Mailing Address - Country:US
Mailing Address - Phone:410-444-3804
Mailing Address - Fax:
Practice Address - Street 1:6802 MCCLEAN BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-7200
Practice Address - Country:US
Practice Address - Phone:410-444-3804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-14
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QA3000XAmbulatory Health Care FacilitiesClinic/CenterAugmentative Communication
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation