| Therapeutic Greenhouse, Llc. | |
|
120 Sister Pierre Dr Ste 506 Baltimore MD 21204-7527 | |
| (410) 670-4769 | |
| (410) 847-2545 |
| Full Name | Therapeutic Greenhouse, Llc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 120 Sister Pierre Dr Ste 506, Baltimore, Maryland |
| Authorized Official Name and Position | Deana Denise Johnson (OWNER/CEO) |
| Authorized Official Contact | 4439836641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Greenhouse, Llc. 722 Dulaney Valley Rd Ste 366 Towson MD 21204-5109 Ph: (410) 670-4769 | Therapeutic Greenhouse, Llc. 120 Sister Pierre Dr Ste 506 Baltimore MD 21204-7527 Ph: (410) 670-4769 |
| NPI Number | 1174183081 |
|---|---|
| Provider Enumeration Date | 06/13/2019 |
| Last Update Date | 08/18/2022 |
| Certification Date | 08/18/2022 |
| Medicare PECOS PAC ID | 3971936386 |
|---|---|
| Medicare Enrollment ID | O20191125002112 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174183081 | NPI | - | NPPES |
| 05 | Medicaid | MD |
| Provider Name | Deana Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508303686 PECOS PAC ID: 3375803661 Enrollment ID: I20180206000884 |
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