Organization
HOME FREE IOP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN BRADLEY-POFF CRNP (PROGRAM ADMINISTRATOR)
(410) 225-7696
Entity
Organization
Contact information
Practice address
723 E PATAPSCO AVE, BALTIMORE, MD 21225-1934
(410) 225-7696
Mailing address
10 W MADISON ST, 11, BALTIMORE, MD 21201-5239
(443) 438-5239
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
905047
MD
Other
Enumeration date
12/11/2013
Last updated
12/11/2013
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