# NSNS REENTRY PALLIATIVE OUTPATIENT CARE, LLC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083479919
- **Authorized official:** JANETTE GONZALEZ-GRAHAM BS, GPC (DIRECTOR)
- **Authorized official phone:** (443) 202-3127

## Contact information

- **Practice address:** 2025 MARYLAND AVE, BALTIMORE, MD 21218-5918
- **Practice address phone:** (443) 202-3127
- **Mailing address:** 2025 MARYLAND AVE, BALTIMORE, MD 21218-5918
- **Mailing address phone:** (443) 202-3127

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | — | NULL | — |

## Other

- **Enumeration date:** 02/20/2024
- **Last updated:** 02/20/2024