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General NPI Number Information
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NPI Number | 1134738909
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Entity Type | Organization
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Legal Business Name | SABINAS HOUSE LLC
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Dates
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Enumeration Date | 07/28/2020
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Last Update Date | 07/28/2020
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Provider Practice Location Address
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Address Line | 2224 DUKELAND ST
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City | BALTIMORE
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State | MD
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Zip | 21216-2812
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Country | US
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Telephone | 443-596-8238
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Fax |
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Provider Business Mailing Address
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Address Line | 435 EASTERN BLVD STE C
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City | ESSEX
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State | MD
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Zip | 21221-6715
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Country | US
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Telephone | 443-596-8238
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. RICHARD KEMMER
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Credential |
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Telephone | 443-596-8238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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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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