| Roberta's House, Inc. | |
|
928 E North Ave Baltimore MD 21202-5825 | |
| (410) 235-6633 | |
| (410) 235-6636 |
| Full Name | Roberta's House, Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 928 E North Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Janaya Latrice Stanley (CLINICAL SUPERVISOR) |
| Authorized Official Contact | 4102356633 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roberta's House, Inc. 928 E North Ave Baltimore MD 21202-5825 Ph: (410) 235-6633 | Roberta's House, Inc. 928 E North Ave Baltimore MD 21202-5825 Ph: (410) 235-6633 |
| NPI Number | 1942868708 |
|---|---|
| Provider Enumeration Date | 06/05/2019 |
| Last Update Date | 08/19/2021 |
| Certification Date | 08/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942868708 | NPI | - | NPPES |
| 351024700 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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