Organization
HUMBLE HAVEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN CLARKE (EXECUTIVE)
(443) 378-3393
Entity
Organization
Contact information
Practice address
3030 GREENMOUNT AVE STE 3003030, BALTIMORE, MD 21218-4991
(443) 373-3393
Mailing address
3030 GREENMOUNT AVE STE 3003030 GREENMOUNT AVE STE 300, 733300, BALTIMORE, MD 21218
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/27/2025
Last updated
09/27/2025
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