Organization
METANOIA LIFE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MONIQUE RODRIGUEZ (OWNER)
(410) 929-1465
Entity
Organization
Contact information
Practice address
6340 SECURITY BLVD STE 100, BALTIMORE, MD 21207-5284
(410) 929-1465
Mailing address
6340 SECURITY BLVD STE 100, BALTIMORE, MD 21207-5284
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/26/2024
Last updated
04/26/2024
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