Organization
MARYLAND COMMUNITY HEALTH INITIATIVES, INC.
Active
Other names
Penn North
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM BROOKS (CEO)
(410) 728-2080
Entity
Organization
Contact information
Practice address
2404 PENNSYLVANIA AVE, BALTIMORE, MD 21217-1722
(410) 728-2080
(410) 728-2038
Mailing address
2404 PENNSYLVANIA AVE, BALTIMORE, MD 21217-1722
(410) 728-2080
(410) 728-2038
Taxonomy
Speciality
Code
Description
License number
State
261QR0800X
Recovery Care Clinic/Center
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404876800
—
MD
Enumeration date
10/21/2016
Last updated
02/28/2020
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