Provider Demographics
NPI:1831626456
Name:EQUALITY LOVE
Entity type:Organization
Organization Name:EQUALITY LOVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED MEDICINE TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:JR
Authorized Official - Credentials:CMT
Authorized Official - Phone:443-869-0497
Mailing Address - Street 1:PO BOX 70142
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-6142
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1404 STRAWFLOWER RD
Practice Address - Street 2:APT E
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-4308
Practice Address - Country:US
Practice Address - Phone:443-869-0497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMT0111577320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities