Sheppard Pratt Health System, INC.
Clinic/Center, Adolescent and Children Mental Health in Frostburg, MD. Organization (NPI-2).
NPI number1104970565
StatusActive
Last updated in NPPESJan 16, 2009
Details
- NPI
- 1104970565
- Entity type
- Organization (NPI-2)
- Legal business name
- Sheppard Pratt Health System, INC.
- Organization subpart
- No
- Enumeration date
- Jan 23, 2007
- Last updated
- Jan 16, 2009
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | 0000 | MD | Yes |
Other names
- Jefferson School At Eckhart (Doing Business As)
Practice location
17000 National Hwy NwFrostburg, MD 21532-3206
Phone 301-777-2258 · Fax 301-777-2364
Mailing address
6501 N Charles StBaltimore, MD 21204-6819
Phone 410-938-3150 · Fax 410-938-3159
Authorized official
Bonnie B Katz
Vp Corporate Business Development
4109383150
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