Healthcare Provider Details

I. General information

NPI: 1477561801
Provider Name (Legal Business Name): RCI CLINICAL PSYCHIATRIC SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3. S FREDERICK STREET SUITE 905
BALTIMORE MD
21202-4304
US

IV. Provider business mailing address

3. S FREDERICK STREET SUITE 905
BALTIMORE MD
21202-4304
US

V. Phone/Fax

Practice location:
  • Phone: 410-327-6503
  • Fax: 410-327-6825
Mailing address:
  • Phone: 410-327-6503
  • Fax: 410-327-6825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number12773
License Number StateMD

VIII. Authorized Official

Name: MS. KATHE A BRYANT
Title or Position: OFFICE MANAGER
Credential:
Phone: 410-327-6503