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General NPI Number Information
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NPI Number | 1992325302
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Entity Type | Organization
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Legal Business Name | BUILDING BRIDGES OF BALTIMORE, LLC
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Dates
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Enumeration Date | 04/26/2020
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 1314 BEDFORD AVE STE 210A
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City | BALTIMORE
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State | MD
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Zip | 21208-6605
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Country | US
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Telephone | 443-744-8994
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Fax |
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Provider Business Mailing Address
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Address Line | 500 MAIN ST STE B
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City | REISTERSTOWN
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State | MD
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Zip | 21136-1997
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Country | US
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Telephone | 410-978-2317
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATE SHAMIS
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Credential |
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Telephone | 410-978-2317
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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