Organization
LANE TREATMENT CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN REESE CAC-AD (EXECUTIVE DIRECTOR)
(410) 837-4292
Entity
Organization
Contact information
Practice address
2117 MARYLAND AVE, SUITE 400, BALTIMORE, MD 21218-5614
(410) 244-7350
(410) 244-7351
Mailing address
2117 MARYLAND AVE, SUITE 400, BALTIMORE, MD 21218-5614
(410) 244-7350
(410) 244-7351
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
MH-1870
MD
261QM0850X
Adult Mental Health Clinic/Center
MH-1858
MD
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
900128
MD
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
905345
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
419787900
—
MD
Enumeration date
01/31/2006
Last updated
02/22/2016
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