Provider Demographics
NPI:1184134538
Name:WE DID DAT RECOVERY CENTER
Entity type:Organization
Organization Name:WE DID DAT RECOVERY CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADDICTION COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUSTLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:MHS, CDC
Authorized Official - Phone:410-419-7792
Mailing Address - Street 1:7231 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-7701
Mailing Address - Country:US
Mailing Address - Phone:410-444-0300
Mailing Address - Fax:410-444-0305
Practice Address - Street 1:609 GEORGE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1353
Practice Address - Country:US
Practice Address - Phone:410-419-7792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2018-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care