Mentor Maryland

NPI #1518900364 in Baltimore, Maryland

Provider Information

NPI Number: 1518900364
Entity Type: Organization
Organization Name: Mentor Maryland
Primary Specialty: Clinic/Center - Adolescent and Children Mental Health
Enumeration Date: Jun 13, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 5720 EXECUTIVE DR
City: Baltimore
State: Maryland
ZIP Code: 21228-1757
Phone: (443) 543-2100

Authorized Official

Name: MR. EDWARD MATRICARDI, LCSW-C
Title: STATE DIRECTOR
Phone: (443) 543-2101

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X	Primary

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