| Psychiatric Rehabilitation Program (prp) | |
|
1055 Taylor Ave Ste 203 Baltimore MD 21286-8333 | |
| (443) 470-2623 | |
| Not Available |
| Full Name | Psychiatric Rehabilitation Program (prp) |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1055 Taylor Ave Ste 203, Baltimore, Maryland |
| Authorized Official Name and Position | Trina Johnson (CEO) |
| Authorized Official Contact | 4434702623 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Rehabilitation Program (prp) 1055 Taylor Ave Baltimore MD 21286-8317 Ph: (443) 470-2623 | Psychiatric Rehabilitation Program (prp) 1055 Taylor Ave Ste 203 Baltimore MD 21286-8333 Ph: (443) 470-2623 |
| NPI Number | 1639740418 |
|---|---|
| Provider Enumeration Date | 07/02/2021 |
| Last Update Date | 09/20/2021 |
| Certification Date | 09/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639740418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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