Organization
BLONNIE'S HOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CLARICE VANBRAKLE (CEO)
(202) 904-4517
Entity
Organization
Contact information
Practice address
1323 KENHILL AVE, BALTIMORE, MD 21213-3800
(410) 929-5423
Mailing address
12138 CENTRAL AVE STE 504, MITCHELLVILLE, MD 20721-1910
(202) 904-4517
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/30/2020
Last updated
07/30/2020
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