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General NPI Number Information
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NPI Number | 1871060293
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Entity Type | Organization
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Legal Business Name | ASSOCIATED SUBSTANCE ABUSE TREATMENT INC.
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Dates
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Enumeration Date | 10/24/2018
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Last Update Date | 10/24/2018
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Provider Practice Location Address
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Address Line | 232 PARK AVE
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City | BALTIMORE
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State | MD
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Zip | 21201-3514
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Country | US
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Telephone | 443-386-7540
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Fax |
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Provider Business Mailing Address
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Address Line | 232 PARK AVE
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City | BALTIMORE
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State | MD
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Zip | 21201-3514
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Country | US
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Telephone | 443-386-7540
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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. LEWIS EVANS
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Credential |
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Telephone | 443-386-7540
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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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