Healthcare Provider Details

I. General information

NPI: 1477409894
Provider Name (Legal Business Name): WARRIOR4GOD ADDICTION MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 N CAREY ST
BALTIMORE MD
21217-2836
US

IV. Provider business mailing address

4318 OWINGS MILLS BLVD
OWINGS MILLS MD
21117-6986
US

V. Phone/Fax

Practice location:
  • Phone: 617-842-8502
  • Fax:
Mailing address:
  • Phone: 617-842-8502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIC ALVIN RITTER
Title or Position: CEO/PHYSICIAN
Credential:
Phone: 617-842-8502