Organization
BALTIMORE DETOX CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON HEABERLIN (CREDENTIALING SPECIALIST)
(410) 415-3385
Entity
Organization
Contact information
Practice address
1825 WOODLAWN DR, WOODLAWN, MD 21207-4080
(410) 457-7396
Mailing address
10461 MILL RUN CIR STE 810, OWINGS MILLS, MD 21117-5549
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
882570000
—
MD
Enumeration date
04/27/2021
Last updated
01/12/2024
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