| Created For Greater Psychiatric Rehabilitation Program | |
|
5411 Old Frederick Rd Ste 8 Baltimore MD 21229-2126 | |
| (443) 315-5007 | |
| Not Available |
| Full Name | Created For Greater Psychiatric Rehabilitation Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5411 Old Frederick Rd Ste 8, Baltimore, Maryland |
| Authorized Official Name and Position | Lakia Chantell Thompson (CEO) |
| Authorized Official Contact | 4432202840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Created For Greater Psychiatric Rehabilitation Program 5411 Old Frederick Rd Ste 8 Baltimore MD 21229-2126 Ph: (443) 315-5007 | Created For Greater Psychiatric Rehabilitation Program 5411 Old Frederick Rd Ste 8 Baltimore MD 21229-2126 Ph: (443) 315-5007 |
| NPI Number | 1568974608 |
|---|---|
| Provider Enumeration Date | 10/30/2017 |
| Last Update Date | 10/19/2023 |
| Certification Date | 10/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568974608 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Maryland) | Primary |
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