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201 N Charles St Suite 200 Baltimore MD 21201-4102 | |
| (410) 576-9191 | |
| (410) 576-9257 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 201 N Charles St, Baltimore, Maryland |
| Authorized Official Name and Position | Clark Joseph Hudak (PRESIDENT/OWNER) |
| Authorized Official Contact | 4105769191 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
201 N Charles St Suite 200 Baltimore MD 21201-4102 Ph: (410) 576-9191 | 201 N Charles St Suite 200 Baltimore MD 21201-4102 Ph: (410) 576-9191 |
| NPI Number | 1962432724 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 05/09/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962432724 | NPI | - | NPPES |
| 094981710 | Medicaid | MD | |
| 023002200 | Medicaid | MD |
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