| NPI | 1750547568 |
|---|---|
| Doing Business As | VILLA MARIA AT LIGHT STREET |
| Doing Business As | BALTIMORE CHILD & ADOLESCENT RESPONSE SYSTEM |
| Entity Type | Organization |
| Authorized Contact | GLORIA REEVES A/R And Billing Manager 667-600-2249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2020-01-02 |