Provider Demographics
NPI:1295439230
Name:REHABILITATION CENTER FOR HUMANITY LLC
Entity type:Organization
Organization Name:REHABILITATION CENTER FOR HUMANITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:FRIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-262-9889
Mailing Address - Street 1:4200 EDMONDSON AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-1600
Mailing Address - Country:US
Mailing Address - Phone:410-362-2983
Mailing Address - Fax:
Practice Address - Street 1:4200 EDMONDSON AVE STE 103
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-1600
Practice Address - Country:US
Practice Address - Phone:410-362-2983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty