Organization
NORTHERN PARKWAY TREATMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BABAK IMANOEL D.O. (MEDICAL DIRECTOR)
(443) 475-0737
Entity
Organization
Contact information
Practice address
3007 E NORTHERN PKWY, BALTIMORE, MD 21214-1419
(443) 475-0737
Mailing address
3007 E NORTHERN PKWY, BALTIMORE, MD 21214-1419
(443) 475-0737
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
905154
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
905154
ADAA CERTIFICATE NUMBER
MD
Enumeration date
06/25/2014
Last updated
11/24/2019
Update your record
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