Provider Demographics
NPI:1962896795
Name:HAMPDEN HEALTH SOLUTIONS
Entity type:Organization
Organization Name:HAMPDEN HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:LGSW
Authorized Official - Phone:443-841-2598
Mailing Address - Street 1:3612 FALLS RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-1869
Mailing Address - Country:US
Mailing Address - Phone:410-467-4357
Mailing Address - Fax:
Practice Address - Street 1:3612 FALLS RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-1869
Practice Address - Country:US
Practice Address - Phone:410-467-4357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD418751200Medicaid