Organization
ISSAIAH HOUSE INC
Active
Other names
Issaiah House Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARRYL EDWARD BRAXTON LCPC 7034 LCADC 1542 (OWNER)
(144) 388-2194
Entity
Organization
Contact information
Practice address
3808 EASTERN AVE, BALTIMORE, MD 21224-4221
(443) 882-1943
(410) 558-6222
Mailing address
3808 EASTERN AVE, BALTIMORE, MD 21224-4221
(443) 882-1943
(410) 558-6222
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/19/2023
Last updated
04/19/2023
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