Provider Demographics
NPI:1275230781
Name:NEW PLACE OF RECOVERY TREATMENT CENTER LLC
Entity Type:Organization
Organization Name:NEW PLACE OF RECOVERY TREATMENT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NNENNA
Authorized Official - Middle Name:DORATHY
Authorized Official - Last Name:EZEH
Authorized Official - Suffix:
Authorized Official - Credentials:CSC-AD
Authorized Official - Phone:443-379-6743
Mailing Address - Street 1:218 E LEXINGTON ST STE 301 & 505
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-3532
Mailing Address - Country:US
Mailing Address - Phone:443-379-6743
Mailing Address - Fax:
Practice Address - Street 1:218 E LEXINGTON ST STE 301&505
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-3532
Practice Address - Country:US
Practice Address - Phone:443-379-6743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-15
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)