| Lane Treatment Center, Llc | |
|
2117 Maryland Ave Suite 400 Baltimore MD 21218-5614 | |
| (410) 244-7350 | |
| (410) 244-7351 |
| Full Name | Lane Treatment Center, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2117 Maryland Ave, Baltimore, Maryland |
| Authorized Official Name and Position | David Engwall (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 4108374292 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lane Treatment Center, Llc 2117 Maryland Ave Suite 400 Baltimore MD 21218-5614 Ph: (410) 244-7350 | Lane Treatment Center, Llc 2117 Maryland Ave Suite 400 Baltimore MD 21218-5614 Ph: (410) 244-7350 |
| NPI Number | 1023470440 |
|---|---|
| Provider Enumeration Date | 03/24/2016 |
| Last Update Date | 03/24/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023470440 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | MH-1870 (Maryland) | Primary |
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