Organization
EASTERN AVENUE HEALTH SOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES WATSON LGSW (DIRECTOR)
(443) 841-2598
Entity
Organization
Contact information
Practice address
5920 EASTERN AVE, BALTIMORE, MD 21224-2730
(410) 631-2772
Mailing address
5920 EASTERN AVE, BALTIMORE, MD 21224-2730
(410) 631-2772
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4211715
—
MD
Enumeration date
05/27/2015
Last updated
05/27/2015
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