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General NPI Number Information
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NPI Number | 1790426070
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Entity Type | Organization
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Legal Business Name | NOAHS ARK BEHAVIORAL HEALTH CENTER
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Dates
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Enumeration Date | 04/02/2022
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Last Update Date | 04/02/2022
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Provider Practice Location Address
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Address Line | 6404 EASTBOURNE AVE
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City | BALTIMORE
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State | MD
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Zip | 21224-6201
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Country | US
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Telephone | 443-255-9670
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Fax |
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Provider Business Mailing Address
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Address Line | 7810 NEW BATTLE GROVE RD
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City | DUNDALK
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State | MD
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Zip | 21222-3559
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Country | US
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Telephone | 410-926-6262
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MISS ELIZABETH BEREZNE
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Credential |
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Telephone | 410-926-6262
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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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