MAN ALIVE INC. NPI 1437488053

NPI Information

MAN ALIVE, INC. is a mental health counselor in Baltimore, MD. MAN ALIVE, INC. NPI is 1437488053. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2117 MARYLAND AVE
BALTIMORE, MD
ZIP 21218-614
Phone: (410) 837-4292
Fax: (410) 837-0639

The provider's authorized official is Karen Reese .
The authorized official title is Executive Director and has the following contact phone number (410) 837-4292.

The CLIA number assigned to this NPI record is 21D2057588 - other - opioid treatment prog with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/10/2009 and was last updated on 12/10/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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