| Powell Recovery Center, Inc. | |
|
14 S Broadway Baltimore MD 21231-1712 | |
| (410) 276-1773 | |
| (410) 276-2056 |
| Full Name | Powell Recovery Center, Inc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 14 S Broadway, Baltimore, Maryland |
| Authorized Official Name and Position | Kim Wireman (PRESIDENT/CEO) |
| Authorized Official Contact | 4436101455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Powell Recovery Center, Inc. 14 S Broadway Baltimore MD 21231-1712 Ph: (410) 276-1773 | Powell Recovery Center, Inc. 14 S Broadway Baltimore MD 21231-1712 Ph: (410) 276-1773 |
| NPI Number | 1699928994 |
|---|---|
| Provider Enumeration Date | 10/30/2008 |
| Last Update Date | 08/12/2024 |
| Certification Date | 08/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699928994 | NPI | - | NPPES |
| 218121500 | Medicaid | MD |
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