Healthcare Provider Details

I. General information

NPI: 1437995685
Provider Name (Legal Business Name): PASSION CARE TREATMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 E LEXINGTON ST STE 602&603
BALTIMORE MD
21202-3532
US

IV. Provider business mailing address

218 E LEXINGTON ST STE 602&603
BALTIMORE MD
21202-3532
US

V. Phone/Fax

Practice location:
  • Phone: 443-536-8014
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RONKE IZIOGO
Title or Position: OWNER
Credential:
Phone: 443-536-8014