Provider Demographics
NPI:1427715408
Name:NEW PLACE OF RECOVERY TREATMENT CENTER
Entity type:Organization
Organization Name:NEW PLACE OF RECOVERY TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NNENNA
Authorized Official - Middle Name:DORATHY
Authorized Official - Last Name:EZEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-379-6743
Mailing Address - Street 1:3717 TALL GRASS CT
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-2824
Mailing Address - Country:US
Mailing Address - Phone:443-379-6743
Mailing Address - Fax:
Practice Address - Street 1:218 E LEXINGTON ST STE 505&301
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-3532
Practice Address - Country:US
Practice Address - Phone:443-379-6743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-24
Last Update Date:2024-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty