Organization
HEBRON HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATANMI OLUSESAN KUFORIJI LCSW-C (PROGRAM DIRECTOR)
(410) 233-1990
Entity
Organization
Contact information
Practice address
2300 GARRISON BLVD STE 101, BALTIMORE, MD 21216-2308
(410) 233-1990
(410) 233-1991
Mailing address
2300 GARRISON BLVD STE 101, BALTIMORE, MD 21216-2308
(410) 233-1990
(410) 233-1991
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
403-43-2500
—
MD
Enumeration date
12/15/2006
Last updated
12/27/2017
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