| Created For Greater Health Systems | |
|
1508 N Caroline St Baltimore MD 21213-2804 | |
| (443) 315-5007 | |
| Not Available |
| Full Name | Created For Greater Health Systems |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1508 N Caroline St, Baltimore, Maryland |
| Authorized Official Name and Position | Lakia Thompson (CEO) |
| Authorized Official Contact | 4433155007 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Created For Greater Health Systems 5411 Old Frederick Rd Ste 9 Baltimore MD 21229-2126 Ph: (443) 315-5007 | Created For Greater Health Systems 1508 N Caroline St Baltimore MD 21213-2804 Ph: (443) 315-5007 |
| NPI Number | 1306472964 |
|---|---|
| Provider Enumeration Date | 03/16/2020 |
| Last Update Date | 03/16/2020 |
| Certification Date | 03/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306472964 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Secondary |
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