The House of the Good Shepherd of the City of Baltimore

NPI #1508980251 in Baltimore, Maryland

Provider Information

NPI Number: 1508980251
Entity Type: Organization
Organization Name: The House of the Good Shepherd of the City of Baltimore
Primary Specialty: Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date: Mar 19, 2007
Last Updated: May 13, 2009

Practice Location

Address: 4100 MAPLE AVENUE
City: Baltimore
State: Maryland
ZIP Code: 21227-4007
Phone: (410) 247-2770

Authorized Official

Name: DERRICK A. BOONE, PSY.D.
Title: PRESIDENT & CEO
Phone: (410) 247-2770

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Emotionally Disturbed Children	322D00000X	Primary

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