Provider Demographics
NPI:1124591680
Name:THE JOHNS HOPKINS HOSPITAL
Entity Type:Organization
Organization Name:THE JOHNS HOPKINS HOSPITAL
Other - Org Name:JHH BROADWAY CENTER FOR ADDICTION WILSON HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REDONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-955-0620
Mailing Address - Street 1:911 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-1119
Mailing Address - Country:US
Mailing Address - Phone:410-955-3007
Mailing Address - Fax:
Practice Address - Street 1:1216 E BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-4710
Practice Address - Country:US
Practice Address - Phone:410-955-5439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-08
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness