Issiaih House 1
NPI #1205460284 in Glen Burnie, Maryland
Provider Information
- NPI Number
- 1205460284
- Entity Type
- Organization
- Organization Name
- Issiaih House 1
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- ISSAIAH HOUSE INC
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Feb 27, 2020
- Last Updated
- Feb 27, 2020
Practice Location
- Address
- 1406B CRAIN HWY S STE 201
- City
- Glen Burnie
- State
- Maryland
- ZIP Code
- 21061-4336
- Phone
- (443) 882-1943
Authorized Official
- Name
- MR. DARRYL BRAXTON, LCAP, LCADC
- Title
- OWNER
- Phone
- (443) 882-1943
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
| Counselor - Mental Health — Mental Health |
| Clinic/Center |
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