VINCENT G. BANKS CENTER FOR RESIDENTIAL SUBSTANCE USE TREATMENT (NPI# 1629629670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629629670 |
| Entity Type | Organization |
| Organization Name | VINCENT G. BANKS CENTER FOR RESIDENTIAL SUBSTANCE USE TREATMENT |
| Practice Address |
12 E Eager St Baltimore MD 21202-2514 |
| Mailing Address |
2641 Maryland Ave Baltimore MD 21218-4518 |
| Practice Telephone | 4108004226 |
| Mailing Telephone | 4108004226 |
| Enumeration Date | 2019-09-21 |
| Last Update Date | 2020-04-22 |
| Authorized Official Name | MR. DAVID HENRY THOMPSON (CEO) |
| Authorized Official Telephone | 4108004226 |
| Authorized Official Credential | LCPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 502387400 | 05 |
| Street Address |
12 E EAGER ST |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21202-2514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750938650 | Anthony Graves | Behavior Technician | 414 Light Street, Baltimore, MD 21202 | 2019-08-25 |
| 1235786609 | Perfected Medical Billing & Consulting Service Inc. | Rehabilitation Counselor | 11 E Mt Royal Avenue, 3rd Flr Ste 2, Baltimore, MD 21202 | 2019-08-21 |
| 1700430246 | Ronie George | Nurse Practitioner | 345 St. Paul Place Dept of Pediatrics, Baltimore, MD 21202 | 2019-08-01 |
| 1750940185 | Katherine Wachter Mullins | Social Worker | 200 East North Ave, Related Services - Rm 210, Baltimore, MD 21202 | 2019-06-10 |
| 1720647175 | Ivelysse Claudio Cortes | Speech-Language Pathologist | Rsu/ofic of Spec Educ- Speech-language Department, 200 E North Avenue, Room 211, Baltimore, MD 21202 | 2019-06-10 |
| 1497314157 | Debera Marie Reznitsky | Speech-Language Pathologist | 200 East North Avenue, Related Services Rm 210, Baltimore, MD 21202 | 2019-06-06 |
| 1154989952 | Zirka Oksanna Hanas | Speech-Language Pathologist | 200 E. North Avenue, Related Services Room #210, Baltimore, MD 21202 | 2019-06-05 |
| 1750946224 | Lareneque Bartholomew | Counselor | 110 East Lexington Street, Suite 200, Baltimore, MD 21202 | 2019-05-09 |
| 1700349602 | Strategies, Inc. Behavior Analysis & Therapeutic Services | Behavioral Analyst | 414 Light Street, Baltimore, Md, Usa, 2103, Baltimore, MD 21202 | 2019-04-09 |
| 1902384068 | Medical Practice Billing and Solution, LLC | Clinic/Center | 224 N Gay Street, Baltimore, MD 21202 | 2018-08-01 |
| Find all providers in zip 21202 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942808050 | Powell Recovery Center, Inc. | Substance Abuse Rehabilitation Facility | 10 S Broadway, Baltimore, MD 21231-1775 | 2020-10-12 |
| 1396343414 | Powell Recovery Center, Inc. | Substance Abuse Rehabilitation Facility | 15 S Broadway, Baltimore, MD 21231-1714 | 2020-10-12 |
| 1457968984 | Powell Recovery Center | Substance Abuse Rehabilitation Facility | 22 S Broadway, Baltimore, MD 21231-1711 | 2020-09-29 |
| 1356956676 | The Elysian Fields Optimum Wellness and Mental Health Group, LLC | Substance Abuse Rehabilitation Facility | 2901 Erdman Ave, Baltimore, MD 21213-1139 | 2020-09-14 |
| 1134731284 | Serenity Keepers of Maryland LLC | Substance Abuse Rehabilitation Facility | 3645 Cottage Ave, Baltimore, MD 21215-7725 | 2020-08-20 |
| 1447875216 | Unlimited Bounds Human Services LLC | Substance Abuse Rehabilitation Facility | 504 Beaumont Ave, Baltimore, MD 21212-4310 | 2020-06-08 |
| 1417577966 | Royal Minds Inc | Substance Abuse Rehabilitation Facility | 928 W Franklin St, Baltimore, MD 21223-1337 | 2020-04-24 |
| 1912527722 | Royal Minds Inc | Substance Abuse Rehabilitation Facility | 533 Chateau Ave, Baltimore, MD 21212-4306 | 2020-04-22 |
| 1841829892 | Cmds Residential | Substance Abuse Rehabilitation Facility | 15 S Fulton Ave, Baltimore, MD 21223-2306 | 2020-04-02 |
| 1306472964 | Created for Greater Health Systems | Substance Abuse Rehabilitation Facility | 1508 N Caroline St, Baltimore, MD 21213-2804 | 2020-03-16 |
| Find all providers in BALTIMORE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.