Organization
CHARM CITY HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVORY GLORIA MARVIN LMSW (CEO)
(443) 675-2036
Entity
Organization
Contact information
Practice address
4312 MAINE AVE, BALTIMORE, MD 21207-3406
(667) 390-0690
Mailing address
3902 LAUSANNE RD, RANDALLSTOWN, MD 21133-4512
(443) 675-2036
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
03/24/2025
Last updated
03/24/2025
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