Provider Demographics
NPI:1952784811
Name:UNITED THERAPEUTIC CENTER INC
Entity Type:Organization
Organization Name:UNITED THERAPEUTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHUKWUNENYE
Authorized Official - Middle Name:
Authorized Official - Last Name:NNAKWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-889-3147
Mailing Address - Street 1:40 S. DUNDALK AVE SUITE 203
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21222
Mailing Address - Country:US
Mailing Address - Phone:443-889-3147
Mailing Address - Fax:
Practice Address - Street 1:40 S DUNDALK AVE STE 203
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21222-4207
Practice Address - Country:US
Practice Address - Phone:443-889-3147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMH 1592251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD423763300Medicaid