Organization
CREATED FOR GREATER PSYCHIATRIC REHABILITATION PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAKIA CHANTELL THOMPSON LGSW (CEO)
(443) 220-2840
Entity
Organization
Contact information
Practice address
5411 OLD FREDERICK RD STE 8, BALTIMORE, MD 21229-2126
(443) 315-5007
Mailing address
5411 OLD FREDERICK RD STE 8, BALTIMORE, MD 21229-2126
(443) 315-5007
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
MD
Other
Enumeration date
10/30/2017
Last updated
10/19/2023
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