Provider Demographics
NPI:1700287315
Name:TUERK HOUSE, INC.
Entity Type:Organization
Organization Name:TUERK HOUSE, INC.
Other - Org Name:HOWARD HOUSE
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, MBA
Authorized Official - Phone:410-233-0684
Mailing Address - Street 1:730 N ASHBURTON ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21216-4703
Mailing Address - Country:US
Mailing Address - Phone:410-233-0684
Mailing Address - Fax:
Practice Address - Street 1:4100 COLLEGE AVE
Practice Address - Street 2:BLDG. 8
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-5506
Practice Address - Country:US
Practice Address - Phone:410-313-1458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUERK HOUSE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-15
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD904733251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD=========OtherEIN