Joppa Health Services, INC.
Clinic/Center, Methadone Clinic in Joppa, MD. Organization (NPI-2).
NPI number1619026432
StatusActive
Last updated in NPPESOct 24, 2011
Details
- NPI
- 1619026432
- Entity type
- Organization (NPI-2)
- Legal business name
- Joppa Health Services, INC.
- Organization subpart
- No
- Enumeration date
- Jan 10, 2007
- Last updated
- Oct 24, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM2800X | Clinic/Center, Methadone Clinic | 11026 | MD | Yes |
Practice location
623 Pulaski Hwy # AJoppa, MD 21085-3914
Phone 410-538-5809 · Fax 410-538-4249
Mailing address
623 Pulaski Hwy # AJoppa, MD 21085-3914
Phone 410-538-5809 · Fax 410-538-4249
Authorized official
Brent Garrett Bowman
Administrative Director
4102594985
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