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Organization
HOMEOSTASIS HAVEN
Active
Organization
HOMEOSTASIS HAVEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LERIN JACKSON CRNP,PMH, MSN, RN (MEDICAL DIRECTOR)
(443) 488-3645
Entity
Organization
Contact information
Practice address
7501 LIBERTY RD, BALTIMORE, MD 21207-3870
(443) 488-3645
Mailing address
1925 HILLENWOOD RD, BALTIMORE, MD 21239-3620
(443) 488-3645
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/16/2023
Last updated
05/16/2023
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