Provider Demographics
NPI:1366429052
Name:HARBEL COMMUNITY ORGANIZATION INC
Entity type:Organization
Organization Name:HARBEL COMMUNITY ORGANIZATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSIGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-444-2100
Mailing Address - Street 1:5807 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-1848
Mailing Address - Country:US
Mailing Address - Phone:410-444-2100
Mailing Address - Fax:410-426-1140
Practice Address - Street 1:5807 HARFORD RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-1848
Practice Address - Country:US
Practice Address - Phone:410-444-2100
Practice Address - Fax:410-426-1140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-23
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175T00000X
MD261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD777821000Medicaid
MD116701400Medicaid