Organization
ESSENTIAL BEHAVIORAL HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH TRACY COLLINS (PRESIDENT AND CEO)
(410) 617-8026
Entity
Organization
Contact information
Practice address
2204 MARYLAND AVE, BALTIMORE, MD 21218-5625
(410) 617-8026
Mailing address
2204 MARYLAND AVE, BALTIMORE, MD 21218-5625
(410) 617-8026
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
905159
SUB ABUSE REGISTRATION
MD
Enumeration date
12/12/2013
Last updated
09/18/2014
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