Charm City Medical Intensive Outpatient Program
Clinic/Center, Mental Health (Including Community Mental Health Center) in Baltimore, MD. Organization (NPI-2).
Details
- NPI
- 1619706462
- Entity type
- Organization (NPI-2)
- Legal business name
- Charm City Medical Intensive Outpatient Program
- Organization subpart
- Yes
- Enumeration date
- Jul 30, 2024
- Certification date
- Sep 18, 2024
- Last updated
- Sep 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
| 251S00000X | Community/Behavioral Health | – | – |
Practice location
2220 Reisterstown RdBaltimore, MD 21217-1928
Phone 301-675-1296 · Fax 443-535-0773
Mailing address
6041 Winter Grain PathClarksville, MD 21029-1224
Phone 301-675-1296 · Fax 443-535-0773
Authorized official
Devesh Dhruva Kanjarpane
Chief Medical Officer
3016463279
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