Provider Demographics
NPI:1063544898
Name:NATIONAL CENTER ON INSTITUTION AND ALTERNATIVES
Entity type:Organization
Organization Name:NATIONAL CENTER ON INSTITUTION AND ALTERNATIVES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:G
Authorized Official - Last Name:NORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:410-944-9994
Mailing Address - Street 1:7205 RUTHERFORD RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2711
Mailing Address - Country:US
Mailing Address - Phone:410-944-9994
Mailing Address - Fax:410-944-7622
Practice Address - Street 1:7205 RUTHERFORD RD
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-2711
Practice Address - Country:US
Practice Address - Phone:410-944-9994
Practice Address - Fax:410-944-7622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3771390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD034104500Medicaid