Organization
PROVIDENCE COMMUNITY PRP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER PAPANIA (PRACTICE MANAGER)
(410) 889-0727
Entity
Organization
Contact information
Practice address
416 E 30TH ST, BALTIMORE, MD 21218-3934
(410) 889-0727
(410) 889-0729
Mailing address
416 E 30TH ST, BALTIMORE, MD 21218-3934
(410) 889-0727
(410) 889-0729
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/22/2017
Last updated
07/21/2022
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