Organization
DRUG TREATMENT CTR - PSYCH. ASSOC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY BIBBO (SENIOR ADMINISTRATOR)
(410) 328-6771
Entity
Organization
Contact information
Practice address
701 W PRATT ST, 3RD FLR., BALTIMORE, MD 21201-1023
(410) 328-2539
(410) 328-8552
Mailing address
701 W PRATT ST, 3RD FLR., BALTIMORE, MD 21201-1023
(410) 328-2539
(410) 328-8552
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
401610600
—
MD
Enumeration date
08/04/2006
Last updated
06/24/2008
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