Provider Demographics
NPI:1518435783
Name:VICTORIA'S PLACE
Entity Type:Organization
Organization Name:VICTORIA'S PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTTEANA
Authorized Official - Middle Name:V
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-388-9654
Mailing Address - Street 1:1800 N CHARLES ST STE 904
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5987
Mailing Address - Country:US
Mailing Address - Phone:443-388-9654
Mailing Address - Fax:443-388-9367
Practice Address - Street 1:1611 KIRKWOOD RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-4937
Practice Address - Country:US
Practice Address - Phone:443-388-9654
Practice Address - Fax:443-388-9367
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE ALBAN INITIATIVE II
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit