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General NPI Number Information
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NPI Number | 1073282364
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Entity Type | Organization
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Legal Business Name | TREYWAY MULTI TREATMENT SERVICES
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Dates
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Enumeration Date | 09/09/2021
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 1839 W NORTH AVE
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City | BALTIMORE
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State | MD
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Zip | 21217-1610
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Country | US
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Telephone | 443-992-0454
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Fax |
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Provider Business Mailing Address
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Address Line | 1839 W NORTH AVE
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City | BALTIMORE
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State | MD
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Zip | 21217-1610
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Country | US
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Telephone | 443-992-0454
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. VARNEY JAMES RICHARDSON III
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Credential |
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Telephone | 443-992-0454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 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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