Provider Demographics
NPI:1194205450
Name:TUERK HOUSE, INC
Entity type:Organization
Organization Name:TUERK HOUSE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR BILLING CLERK
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-467-5291
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:410-467-5291
Mailing Address - Fax:410-800-2928
Practice Address - Street 1:5665 PURDUE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-2802
Practice Address - Country:US
Practice Address - Phone:410-467-5291
Practice Address - Fax:410-800-2928
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUERK HOUSE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-16
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDBH000896324500000X
MDBH000897324500000X
MD904734324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDBH000896OtherMARYLAND DEPARTMENT OF HEALTH BEHAVIORAL HEALTH ADMINISTRATION
MDBH000897OtherMARYLAND DEPARTMENT OF HEALTH BEHAVIORAL HEALTH ADMINISTRATION
MD902140OtherMARYLAND DEPARTMENT OF HEALTH BEHAVIORAL HEALTH ADMINISTRATION