Healthcare Provider Details

I. General information

NPI: 1568305407
Provider Name (Legal Business Name): TUERK HOUSE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ELSINORE AVE
BALTIMORE MD
21216-1655
US

IV. Provider business mailing address

730 N ASHBURTON ST
BALTIMORE MD
21216-4703
US

V. Phone/Fax

Practice location:
  • Phone: 667-212-3631
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: KISUN PETERS-DIAZ
Title or Position: DIRECTOR OF BUSINESS DEVELOPMENT
Credential:
Phone: 917-861-2531