Organization
LANE TREATMENT CENTER, LLC
Active
Organization
LANE TREATMENT CENTER, LLC
Active
Parent organization
MAN ALIVE, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAN ALIVE, INC.
Authorized official
DAVID ENGWALL LCPC (DIRECTOR OF OPERATIONS)
(410) 837-4292
Entity
Organization
Contact information
Practice address
2117 MARYLAND AVE, SUITE 400, BALTIMORE, MD 21218-5614
(410) 244-7350
(410) 244-7351
Mailing address
2117 MARYLAND AVE, SUITE 400, BALTIMORE, MD 21218-5614
(410) 244-7350
(410) 244-7351
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
MH-1858
MD
Other
Enumeration date
03/16/2016
Last updated
03/16/2016
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