Provider Demographics
NPI:1003598913
Name:FAMILYCHOICE CLINIC LLC
Entity Type:Organization
Organization Name:FAMILYCHOICE CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET T
Authorized Official - Middle Name:T
Authorized Official - Last Name:OWOLABI
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:443-825-2955
Mailing Address - Street 1:5513 YORK RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-3804
Mailing Address - Country:US
Mailing Address - Phone:443-825-2955
Mailing Address - Fax:443-835-1446
Practice Address - Street 1:4811 LAUREL AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-6401
Practice Address - Country:US
Practice Address - Phone:443-825-2955
Practice Address - Fax:667-212-2682
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILYCHOICE CLINIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-01
Last Update Date:2023-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit