Healthcare Provider Details

I. General information

NPI: 1073292330
Provider Name (Legal Business Name): HIS KEEP SAKE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2023
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6340 SECURITY BLVD STE 100, A3, A15, A17, A45, A46
BALTIMORE MD
21207-5284
US

IV. Provider business mailing address

6340 SECURITY BLVD STE 100
GWYNN OAK MD
21207-5284
US

V. Phone/Fax

Practice location:
  • Phone: 443-473-5080
  • Fax:
Mailing address:
  • Phone: 410-215-0487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. NICOLE ALSTON
Title or Position: CEO
Credential:
Phone: 410-215-0487