1598025835 NPI number — RECLAIMING OUR CHILDREN AND COMMUNITY PROJECT, INC.

Table of content: (NPI 1598025835)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598025835 NPI number — RECLAIMING OUR CHILDREN AND COMMUNITY PROJECT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RECLAIMING OUR CHILDREN AND COMMUNITY PROJECT, INC.
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:
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:
1598025835
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/27/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 29265
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21205-0565
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-226-6866
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1900 E NORTHERN PKWY
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21239-2113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-759-9706
Provider Business Practice Location Address Fax Number:
443-759-9707
Provider Enumeration Date:
05/21/2012

Additional Information

Authorized Official

Authorized Official Last Name:
WILSON
Authorized Official First Name:
DANTE
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
443-226-6866

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  MH-1074 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251S00000X , with the licence number: MH-1875 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 254803800 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com