# CREATED FOR GREATER HEALTH SYSTEMS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** -
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1306472964
- **Legal business name:** -
- **Authorized official:** LAKIA THOMPSON LCSW-C (CEO)
- **Authorized official phone:** (443) 315-5007

## Contact information

- **Practice address:** 1508 N CAROLINE ST, BALTIMORE, MD 21213-2804
- **Practice address phone:** (443) 315-5007
- **Mailing address:** 5411 OLD FREDERICK RD STE 9, BALTIMORE, MD 21229-2126
- **Mailing address phone:** (443) 315-5007
- **Mailing address fax:** (443) 251-5395

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |
| 324500000X | Substance Abuse Rehabilitation Facility | — | NULL | — |

## Other

- **Enumeration date:** 03/16/2020
- **Last updated:** 03/16/2020