Organization
NSNS REENTRY PALLIATIVE OUTPATIENT CARE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANETTE GONZALEZ-GRAHAM BS, GPC (DIRECTOR)
(443) 202-3127
Entity
Organization
Contact information
Practice address
2025 MARYLAND AVE, BALTIMORE, MD 21218-5918
(443) 202-3127
Mailing address
2025 MARYLAND AVE, BALTIMORE, MD 21218-5918
(443) 202-3127
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
02/20/2024
Last updated
02/20/2024
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