| NPI | 1295133692 |
|---|---|
| Other Name | CCS ELDERSBURG - FACILITY FOR MEDICAID |
| Entity Type | Organization |
| Authorized Contact | MARK DONOVAN President 410-740-8066 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X (Licence: MD 906055) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2022-12-01 |