|
| |
|
1029 E Baltimore St Baltimore MD 21202-4705 | |
| (410) 550-7680 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1029 E Baltimore St, Baltimore, Maryland |
| Authorized Official Name and Position | Shavonda Keating (DIRECTOR OF PROVIDER ENROLLMENT) |
| Authorized Official Contact | 4109336430 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6201 Greenleigh Ave Baltimore MD 21220-2004 Ph: (410) 933-4853 | 1029 E Baltimore St Baltimore MD 21202-4705 Ph: (410) 550-7680 |
| NPI Number | 1013273838 |
|---|---|
| Provider Enumeration Date | 04/05/2012 |
| Last Update Date | 11/17/2023 |
| Certification Date | 11/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013273838 | NPI | - | NPPES |
| 904396 | Other | MD | OHCQ CERT# |
Trinity Healthcare Services Incorporated Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4701 Belair Rd, Baltimore, MD 21206 Phone: 410-325-1850 | |
Michael B. Freedman Phd Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6006 Park Heights Ave, Baltimore, MD 21215 Phone: 410-790-8433 Fax: 443-501-3379 | |
Sankofa Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 Key Hwy, Unit 442, Baltimore, MD 21230 Phone: 301-758-3682 | |
Home Free Iop Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 W Madison St Ste 11, Baltimore, MD 21201 Phone: 443-438-5239 | |
All Walks Of Life, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 E 25th St, Baltimore, MD 21218 Phone: 410-558-0019 | |
Darryl M Coleman Md Pa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 N Monroe St, Baltimore, MD 21223 Phone: 443-708-4391 Fax: 443-708-4436 |