# HERITAGE TREATMENT CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HERITAGE TREATMENT CENTER LLC, HERITAGE TREATENT CENTER INC, HERITAGE TREATMENT CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609506815
- **Authorized official:** TIFFANY LYNNELL BEANE (CO-OWNER)
- **Authorized official phone:** (443) 873-9389

## Contact information

- **Practice address:** 4200 EDMONDSON AVE STE 102, BALTIMORE, MD 21229-1600
- **Practice address phone:** (443) 224-0655
- **Mailing address:** 4200 EDMONDSON AVE STE 102, BALTIMORE, MD 21229-1600
- **Mailing address phone:** (443) 224-0655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/13/2022
- **Last updated:** 04/04/2025