Issaiah House INC
Counselor, Professional in Baltimore, MD. Organization (NPI-2).
NPI number1891278024
StatusActive
Last updated in NPPESMay 18, 2021
Details
- NPI
- 1891278024
- Entity type
- Organization (NPI-2)
- Legal business name
- Issaiah House INC
- Organization subpart
- Yes
- Enumeration date
- Sep 13, 2018
- Certification date
- May 18, 2021
- Last updated
- May 18, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | – | – | Yes |
Practice location
3808 Eastern AveBaltimore, MD 21224-4221
Phone 443-882-1943
Mailing address
919 Calwell RdBaltimore, MD 21229-5006
Phone 144-388-2194
Other practice locations
1705 Edmondson Ave
Baltimore, MD 21223-1222
Baltimore, MD 21223-1222
Phone 443-882-1943
17 Warren Rd Ste 20b
Baltimore, MD 21208-5334
Baltimore, MD 21208-5334
Phone 443-882-1943
Authorized official
Darryl Edward Braxton
Owner
4438821943
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