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General NPI Number Information
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NPI Number | 1902529530
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Entity Type | Organization
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Legal Business Name | ALLIANZE INC
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Dates
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Enumeration Date | 09/20/2022
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Last Update Date | 08/23/2023
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Provider Practice Location Address
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Address Line | 526 S CONKLING ST
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City | BALTIMORE
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State | MD
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Zip | 21224-4201
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Country | US
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Telephone | 443-759-1137
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Fax |
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Provider Business Mailing Address
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Address Line | 9609 WICKSTEAD CT
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City | PERRY HALL
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State | MD
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Zip | 21128-8977
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Country | US
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Telephone | 443-759-1137
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PHILIP OKOJIE
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Credential |
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Telephone | 443-759-1137
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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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