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General NPI Number Information
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NPI Number | 1013575638
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Entity Type | Organization
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Legal Business Name | THE REGENERATION PROJECT LLC
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Dates
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Enumeration Date | 05/29/2019
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Last Update Date | 05/29/2019
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Provider Practice Location Address
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Address Line | 2701 N CHARLES ST STE 401
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City | BALTIMORE
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State | MD
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Zip | 21218-5061
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Country | US
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Telephone | 410-254-6175
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Fax | 410-254-6175
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Provider Business Mailing Address
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Address Line | 2701 N CHARLES ST STE 401
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City | BALTIMORE
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State | MD
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Zip | 21218-5061
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Country | US
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Telephone | 410-254-6175
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RODDRICK STOKES
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Credential | CPRP
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Telephone | 410-254-6175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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