Provider Demographics
NPI:1932668506
Name:FREE BALTIMORE, LLC
Entity Type:Organization
Organization Name:FREE BALTIMORE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:NORTHWEST REGISTERED
Authorized Official - Middle Name:AGENT
Authorized Official - Last Name:SERVICES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-416-5667
Mailing Address - Street 1:PO BOX 26662
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-0462
Mailing Address - Country:US
Mailing Address - Phone:443-478-0013
Mailing Address - Fax:
Practice Address - Street 1:1120 N CHARLES ST STE 303
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5592
Practice Address - Country:US
Practice Address - Phone:443-759-7075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-13
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health