Organization
GRASSROOTS CRISIS INTERVENTION CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIANA IZRAELSON LCADC (EXECUTIVE DIRECTOR)
(410) 531-6006
Entity
Organization
Contact information
Practice address
8990 OLD ANNAPOLIS RD STE A, COLUMBIA, MD 21045-2182
(410) 531-6677
Mailing address
6700 FREETOWN RD, COLUMBIA, MD 21044-4137
(410) 531-6006
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/04/2024
Last updated
06/04/2024
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