Organization
POWELL RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAYTHE JOHNSON LCSW-C (VICE PRESIDENT BILLING)
(410) 276-1773
Entity
Organization
Contact information
Practice address
3038 GWYNNS FALLS PKWY, BALTIMORE, MD 21216-2720
(410) 276-1773
Mailing address
14 S BROADWAY, BALTIMORE, MD 21231-1712
(410) 276-1773
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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