1780652479 NPI number — CONTIUNUUM CARE CORPORATION

Table of content: (NPI 1780652479)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780652479 NPI number — CONTIUNUUM CARE CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONTIUNUUM CARE CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CONTINUUMCARE AT SYKESVILLE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780652479
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
901 DULANEY VALLEY ROAD
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
TOWSON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-938-8703
Provider Business Mailing Address Fax Number:
410-832-5640

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
901 DULANEY VALLEY ROAD
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
TOWSON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-938-8703
Provider Business Practice Location Address Fax Number:
410-832-5640
Provider Enumeration Date:
03/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SCHWARTZ
Authorized Official First Name:
HENRY
Authorized Official Middle Name:
E
Authorized Official Title or Position:
COUNSEL
Authorized Official Telephone Number:
410-938-8703

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  06-007 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X , with the licence number: 05007 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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