| Vincent G. Banks Center For Residential Substance Use Treatment | |
|
12 E Eager St Baltimore MD 21202-2514 | |
| (410) 800-4226 | |
| Not Available |
| Full Name | Vincent G. Banks Center For Residential Substance Use Treatment |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 12 E Eager St, Baltimore, Maryland |
| Authorized Official Name and Position | David Henry Thompson (CEO) |
| Authorized Official Contact | 4108004226 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vincent G. Banks Center For Residential Substance Use Treatment 2641 Maryland Ave Baltimore MD 21218-4518 Ph: (410) 800-4226 | Vincent G. Banks Center For Residential Substance Use Treatment 12 E Eager St Baltimore MD 21202-2514 Ph: (410) 800-4226 |
| NPI Number | 1629629670 |
|---|---|
| Provider Enumeration Date | 09/21/2019 |
| Last Update Date | 02/26/2021 |
| Certification Date | 02/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629629670 | NPI | - | NPPES |
| 502387400 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Primary |
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