Organization
POWELL RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAYTHE MOYER LCSW-C (BILLING DIRECTOR)
(443) 974-3027
Entity
Organization
Contact information
Practice address
14 S BROADWAY, BALTIMORE, MD 21231-1712
(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
904345
MD
Other
Enumeration date
06/13/2017
Last updated
07/21/2022
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