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General NPI Number Information
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NPI Number | 1114840121
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Entity Type | Organization
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Legal Business Name | HENRY RECOVERY HOUSE AND MENTAL HEALTH THERAPY LLC
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Dates
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Enumeration Date | 08/04/2026
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Last Update Date | 08/04/2026
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Provider Practice Location Address
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Address Line | 3803 EASTERN AVE 5403 GRADIN AVE
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City | BALTIMORE
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State | MD
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Zip | 21224
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Country | US
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Telephone | 443-854-5033
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Fax | 443-854-5033
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Provider Business Mailing Address
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Address Line | 5403 GRADIN AVE
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City | BALTIMORE
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State | MD
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Zip | 21207-6109
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Country | US
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Telephone | 443-854-5033
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Fax | 443-854-5033
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Authorized Official
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Title or Position | OWNER
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Name | ETCHU ARREY ABUNAW
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Credential | LCPC
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Telephone | 443-854-5033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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