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1548984404
MAGELLAN PROVIDER SERVICES OF CA PC
COLUMBIA, MD
NPI
1548984404
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Entity Type
Organization
Authorized Contact
BRIAN FREY
Chief Financial Officer
314-406-8632
Organization Subpart ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2022-10-03
Last Update Date
2022-10-03
Business Address
MAGELLAN PROVIDER SERVICES OF CA PC
8621 ROBERT FULTON DR
COLUMBIA, MD 21046-2620
Phone number: 833-605-0634
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Mailing Address
MAGELLAN PROVIDER SERVICES OF CA PC
8621 ROBERT FULTON DR
COLUMBIA, MD 21046-2620
Phone number: 833-605-0634
Copy
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