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Organization
BUILDING COMMUNITIES TODAY FOR TOMORROW
Active
Organization
BUILDING COMMUNITIES TODAY FOR TOMORROW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CEDRIC LEMAR TUCKER (PRESIDENT/CEO)
(410) 467-6600
Entity
Organization
Contact information
Practice address
2901 DRUID PARK DR, SUITE A210, BALTIMORE, MD 21215-8102
(410) 467-6600
(410) 225-9110
Mailing address
2901 DRUID PARK DR, SUITE A210, BALTIMORE, MD 21215-8102
(410) 467-6600
(410) 225-9110
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LC4081
MD
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC4081
MD
101YM0800X
Mental Health Counselor
LC4081
MD
101YP2500X
Professional Counselor
LC4081
MD
Other
Enumeration date
08/07/2012
Last updated
08/07/2012
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