Organization
SOUTH BALTINORE C.A.P. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHIRLEY M ROSE CCDC-AD (EXECUTIVE DIRECTOR)
(410) 752-2475
Entity
Organization
Contact information
Practice address
1435 S HANOVER ST, BALTIMORE, MD 21230-4438
(410) 752-2475
(410) 385-1466
Mailing address
1435 S HANOVER ST, BALTIMORE, MD 21230-4438
(410) 752-2475
(410) 385-1466
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
11174
MD
Other
Enumeration date
11/09/2005
Last updated
08/22/2020
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