1861818312 NPI number — THE RESOURCE GROUP COUNSELING & EDUCATION CENTER

Table of content: PAUL MARTIN KNECHTGES MD (NPI 1518048636)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861818312 NPI number — THE RESOURCE GROUP COUNSELING & EDUCATION CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE RESOURCE GROUP COUNSELING & EDUCATION CENTER
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:
Provider Other Organization Name Type Code:
6
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:
1861818312
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/09/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8501 LASALLE RD
Provider Second Line Business Mailing Address:
SUITE 115B
Provider Business Mailing Address City Name:
TOWSON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21286
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-337-7772
Provider Business Mailing Address Fax Number:
410-337-8729

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8501 LASALLE RD
Provider Second Line Business Practice Location Address:
SUITE 115B
Provider Business Practice Location Address City Name:
TOWSON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21286
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-337-7772
Provider Business Practice Location Address Fax Number:
410-337-8729
Provider Enumeration Date:
03/07/2014

Additional Information

Authorized Official

Authorized Official Last Name:
DRISCOLL
Authorized Official First Name:
ELLIOTT
Authorized Official Middle Name:
JOHN
Authorized Official Title or Position:
DIRECTOR/CEO
Authorized Official Telephone Number:
410-337-7772

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  904286 , 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)

  • Identifier: 4216199 00 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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