Healthcare Provider Details
I. General information
NPI: 1548947864
Provider Name (Legal Business Name): MNK COMMUNITY RESOURCES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/28/2023
Last Update Date: 06/28/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2518 N CHARLES ST UNIT 1
BALTIMORE MD
21218-4600
US
IV. Provider business mailing address
2518 N CHARLES ST APT 1
BALTIMORE MD
21218-4600
US
V. Phone/Fax
- Phone: 410-205-2401
- Fax:
- Phone: 410-205-2401
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARK
KARCHER
Title or Position: CEO
Credential:
Phone: 410-916-0194