Ridge 103 LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

RIDGE 103 LLC

Practice address

1235 E Monument St
Baltimore, MD 21202-5327

Phone

(410) 373-0070

Fax

(410) 327-0542

NPI assigned

May 18, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Orlando Ross Davis, M.D.

Title

Medical Director

Phone

(410) 373-0070

Specialties & licenses 1

Addresses

Other names 1

• Ridge 103 OMHC Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851509103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 EAST MONUMENT STREET",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21202",
            "telephone_number": "410-373-0070",
            "fax_number": "410-327-0542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 E MONUMENT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212025327",
            "telephone_number": "410-373-0070",
            "fax_number": "410-327-0542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGE 103 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ORLANDO",
        "authorized_official_middle_name": "ROSS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "410-373-0070",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ridge 103 OMHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shayla Riddick, LCSW-C
• Emily Riddle
• Julia Riddle, MD
• Heather Riddler, MD
• Kristin Ridenour, MPH, PA-C
• Isobel Ridge Anderson
• Ridgecroft Residence Inc
• Natalie Claire Ridgely, PHD
• Shandra Ridgely, LGPC
• Kristen Ridgeway, PA

• Mental Health Clinic/Center (Including Community Mental Health Center) in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.