Organization
VINCENT G. BANKS CENTER FOR RESIDENTIAL SUBSTANCE USE TREATMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID HENRY THOMPSON LCPC (CEO)
(410) 800-4226
Entity
Organization
Contact information
Practice address
12 E EAGER ST, BALTIMORE, MD 21202-2514
(410) 800-4226
Mailing address
2641 MARYLAND AVE, BALTIMORE, MD 21218-4518
(410) 800-4226
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
502387400
—
MD
Enumeration date
09/21/2019
Last updated
02/26/2021
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