Healthcare Provider Details

I. General information

NPI: 1063692655
Provider Name (Legal Business Name): BALTIMORE CARES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2007
Last Update Date: 05/10/2023
Certification Date: 05/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 GARRISON BLVD STE 150
BALTIMORE MD
21216-2316
US

IV. Provider business mailing address

2300 GARRISON BLVD STE 150
BALTIMORE MD
21216-2316
US

V. Phone/Fax

Practice location:
  • Phone: 410-233-3111
  • Fax: 410-233-3222
Mailing address:
  • Phone: 410-233-3111
  • Fax: 410-233-3222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number903365
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number903365
License Number StateMD

VIII. Authorized Official

Name: MR. MICHAEL KIRK DOUGLAS
Title or Position: DIRECTOR
Credential: MHS, CAC-AD, ABD
Phone: 410-233-3111