Provider Demographics
NPI:1699406884
Name:ONE PROMISE HALFWAY HOUSE
Entity Type:Organization
Organization Name:ONE PROMISE HALFWAY HOUSE
Other - Org Name:ONE PROMISE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:LIPPENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-835-2681
Mailing Address - Street 1:6207 BELAIR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-1942
Mailing Address - Country:US
Mailing Address - Phone:443-835-2681
Mailing Address - Fax:
Practice Address - Street 1:6707 YOUNGSTOWN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21222-1026
Practice Address - Country:US
Practice Address - Phone:443-835-2681
Practice Address - Fax:410-624-5114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-20
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder