Provider Demographics
NPI:1649627548
Name:SUPPORTIVE HOUSING GROUP, INC.
Entity type:Organization
Organization Name:SUPPORTIVE HOUSING GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SCOTTEANA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:410-276-4050
Mailing Address - Street 1:1600 RUTLAND AVE
Mailing Address - Street 2:MAIN OFFICE
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-2469
Mailing Address - Country:US
Mailing Address - Phone:410-276-4050
Mailing Address - Fax:410-276-4057
Practice Address - Street 1:1600 RUTLAND AVE
Practice Address - Street 2:MAIN OFFICE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-2469
Practice Address - Country:US
Practice Address - Phone:410-276-4050
Practice Address - Fax:410-276-4057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management