Healthcare Provider Details

I. General information

NPI: 1649921719
Provider Name (Legal Business Name): MONTARI HEALTH & REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2022
Last Update Date: 01/11/2022
Certification Date: 01/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3415 W FRANKLIN ST
BALTIMORE MD
21229-3054
US

IV. Provider business mailing address

10074 PADUA WAY
OWINGS MILLS MD
21117-4065
US

V. Phone/Fax

Practice location:
  • Phone: 443-454-5075
  • Fax:
Mailing address:
  • Phone: 443-454-5075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: CARLA HALL
Title or Position: CEO
Credential:
Phone: 443-454-5075