Healthcare Provider Details

I. General information

NPI: 1962336511
Provider Name (Legal Business Name): MISHPACHA REFUAH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 N CHARLES ST
BALTIMORE MD
21201-3740
US

IV. Provider business mailing address

1 N CHARLES ST
BALTIMORE MD
21201-3740
US

V. Phone/Fax

Practice location:
  • Phone: 646-406-0158
  • Fax:
Mailing address:
  • Phone: 646-406-0158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: LEAH TAYLOR-III
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 646-406-0158