Organization
2 GOD B THE GLORY RECOVERY FAMILY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROWENA SIMMONS (EXECUTIVE DIRECTOR)
(301) 494-3564
Entity
Organization
Contact information
Practice address
339 BLOOM ST, BALTIMORE, MD 21217-4598
(301) 494-3564
Mailing address
PO BOX 67254, BALTIMORE, MD 21215-0009
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
21583
MD
251V00000X
Voluntary or Charitable Agency
25844
—
Other
Enumeration date
10/06/2017
Last updated
10/06/2017
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