Healthcare Provider Details
I. General information
NPI: 1942133343
Provider Name (Legal Business Name): WARRIOR4GOD ADDICTION MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
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
- Phone: 443-377-6774
- Fax:
- Phone: 617-842-8502
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ERIC
ALVIN
RITTER
Title or Position: CEO/PHYSICIAN
Credential:
Phone: 617-842-8502