Organization
TRANSFORMATIONAL RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENYA CONWAY (CO -OWNER)
(443) 398-1414
Entity
Organization
Contact information
Practice address
3410 CHESTERFIELD AVE, BALTIMORE, MD 21213-1802
(443) 398-1414
Mailing address
535 DUNDALK AVE, BALTIMORE, MD 21224-2903
(443) 398-1414
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
211011744
BHA LICENSE
MD
Enumeration date
12/24/2021
Last updated
12/24/2021
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