NPI | 1902348659 |
---|---|
Doing Business As | 1ST MEDICAL PAINREHAB CENTER |
Entity Type | Organization |
Authorized Contact | ROSEMARY INGADO Clinical Administrator 410-956-6800 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
261QR0400X Clinic/Center, Rehabilitation | |
261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
1041C0700X Social Worker, Clinical | |
171W00000X Contractor (Licence: MD D40904) | |
174400000X Specialist | |
261QM0850X Clinic/Center, Adult Mental Health | |
Enumeration Date | 2016-11-11 |
Last Update Date | 2022-01-23 |