Organization
POWELL RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAYTHE M MOYER (LCSW-C)
(410) 276-1773
Entity
Organization
Contact information
Practice address
14 S BROADWAY, BALTIMORE, MD 21231-1712
(410) 276-1773
(410) 276-2056
Mailing address
14 S BROADWAY, BALTIMORE, MD 21231-1712
(410) 276-1773
(410) 276-2056
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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