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General NPI Number Information
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NPI Number | 1043048275
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Entity Type | Organization
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Legal Business Name | DIG-IN-TO CHANGE/KNOWLEDGE, POWER AND WISDOM, LLC
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Dates
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Enumeration Date | 07/22/2024
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 16 W 25TH ST STE 202
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City | BALTIMORE
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State | MD
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Zip | 21218-5002
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Country | US
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Telephone | 410-501-4759
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Fax | 443-377-0795
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Provider Business Mailing Address
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Address Line | 16 W 25TH ST STE 202
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City | BALTIMORE
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State | MD
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Zip | 21218-5002
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Country | US
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Telephone | 410-501-4759
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Fax | 443-377-0795
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Authorized Official
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Title or Position | OWNER/COO
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Name | MARIE ANTOINETTE DIGGINS
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Credential |
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Telephone | 410-501-4759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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