Organization
POWELL RECOVERY CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FAYTHE JOHNSON LCSW-C (VP TX COORDINATION & BILLING)
(410) 276-1773
Entity
Organization
Contact information
Practice address
1111 WHITMORE AVE, BALTIMORE, MD 21216-4426
(410) 276-1773
Mailing address
14 S BROADWAY, BALTIMORE, MD 21231-1712
(410) 276-1773
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/21/2019
Last updated
06/21/2019
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