Healthcare Provider Details

I. General information

NPI: 1982928305
Provider Name (Legal Business Name): TOTAL HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2010
Last Update Date: 03/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 W SARATOGA ST
BALTIMORE MD
21223-1749
US

IV. Provider business mailing address

1501 W SARATOGA ST
BALTIMORE MD
21223-1749
US

V. Phone/Fax

Practice location:
  • Phone: 410-383-7197
  • Fax: 410-383-3131
Mailing address:
  • Phone: 410-383-7197
  • Fax: 410-383-3131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. WILLIAM JOSEPH JONES JR.
Title or Position: COUNSELOR
Credential:
Phone: 410-383-7197