Organization
BALTIMORE COMMUNITY RESOURCE CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN WOODELL (DIRECTOR)
(410) 366-1717
Entity
Organization
Contact information
Practice address
3623 PARKDALE AVE, BALTIMORE, MD 21211-1326
(410) 366-1717
(410) 889-4167
Mailing address
21 W 25TH ST, BALTIMORE, MD 21218-5003
(410) 366-1717
(410) 889-4167
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
903995
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
417128400
—
MD
Enumeration date
05/09/2012
Last updated
05/09/2012
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