Organization
TREATMENT RESOURCES FOR YOUTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LATAVIA LITTLE LCSW-C (EXECUTIVE DIRECTOR)
(410) 366-2123
Entity
Organization
Contact information
Practice address
2517 N CHARLES ST, BALTIMORE, MD 21218-4602
(410) 366-2123
Mailing address
2517 N CHARLES ST, BALTIMORE, MD 21218-4602
(410) 366-2123
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
10120
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196361900
—
MD
Enumeration date
11/07/2005
Last updated
02/15/2012
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