Healthcare Provider Details

I. General information

NPI: 1770233934
Provider Name (Legal Business Name): TRANSFORMING YOUTHS INTO ADULTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 12/07/2024
Certification Date: 12/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 N CHARLES ST 2ND FL REAR
BALTIMORE MD
21201-5053
US

IV. Provider business mailing address

518 N CHARLES ST 2ND FL REAR
BALTIMORE MD
21201-5053
US

V. Phone/Fax

Practice location:
  • Phone: 443-208-2645
  • Fax:
Mailing address:
  • Phone: 443-208-2645
  • 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 Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. KAREEN HILL
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW
Phone: 443-208-2645