| True Vine Health Llc | |
|
5629 Harford Rd Ste 102 Baltimore MD 21214-2272 | |
| (667) 600-9450 | |
| Not Available |
| Full Name | True Vine Health Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5629 Harford Rd Ste 102, Baltimore, Maryland |
| Authorized Official Name and Position | Marcus Motton (PROGRAM DIRECTOR) |
| Authorized Official Contact | 6676009450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| True Vine Health Llc 5629 Harford Rd Ste 102 Baltimore MD 21214-2272 Ph: (667) 600-9450 | True Vine Health Llc 5629 Harford Rd Ste 102 Baltimore MD 21214-2272 Ph: (667) 600-9450 |
| NPI Number | 1164119442 |
|---|---|
| Provider Enumeration Date | 04/18/2023 |
| Last Update Date | 04/18/2023 |
| Certification Date | 04/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164119442 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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