HERITAGE TREATMENT CENTER
Internal Medicine (Addiction Medicine)

Address: 4200 Edmondson Ave Ste 102, Baltimore, MD 21229-1600

HERITAGE TREATMENT CENTER (NPI# 1568058196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1568058196
Entity Type Organization
Organization Name HERITAGE TREATMENT CENTER
Practice Address 4200 Edmondson Ave Ste 102
Baltimore
MD 21229-1600
Practice Telephone 4432240655
Mailing Address 4200 Edmondson Ave Ste 102
Baltimore
MD 21229-1600
Mailing Telephone 4432240655
Certification Date 2020-12-17
Enumeration Date 2020-12-17
Last Update Date 2020-12-17
Authorized Official Telephone 4432240655
Authorized Official Credential LMSW
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Taxonomy Group
Y 207RA0401X Internal Medicine
Specialization: Addiction Medicine
193400000X SINGLE SPECIALTY GROUP Allopathic & Osteopathic Physicians

Office Location

Street Address 4200 EDMONDSON AVE STE 102
City BALTIMORE
State MD
Zip Code 21229-1600

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1922628783 Rehabilitation Center for Humanity LLC Case Management 4200 Edmondson Ave Ste 103, Baltimore, MD 21229-1600 2020-04-22

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1265068373 Bodyworks Medical Clinic/Center · Multi-Specialty St. Agnes Medical Center, 3455 Wilkens Ave Suite 100, Baltimore, MD 21229 2020-03-20
1750932430 Amanda Felix Nurse Practitioner · Psychiatric/Mental Health 5411 Old Frederick Road, Catonsville, MD 21229 2019-09-24
1497317853 Wakeelat A Adeoye Nurse Practitioner · Psychiatric/Mental Health 5411 0ld Fredrick Rd, Suite 7, Baltimore, MD 21229 2019-07-05
1477051779 Shahin Vohara Dentist · General Practice Dental Dreams, 4510 Edmondson Avenue, Edmondson Village Shopping Center, Baltimore, MD 21229 2018-02-01
1386179299 Sharon Mccollough Counselor · Mental Health 3219 Phelps Lane, First Floor, Baltimore, MD 21229 2017-04-28
1184175697 Yekeen Odewale Registered Nurse · Psychiatric/Mental Health, Adult 5411 Old Frederick Rd Ste 7, Baltimore, MD 21229 2016-10-19
1942608070 Charity Ashe Social Worker 4024 Colborne Rd, Baltimore, MD 21229 2014-12-05
1376947127 Sumanya Venkat Rao Dentist 4510 Edmondson Ave, Baltimore, MD 21229 2014-10-21
1497091573 Anita Phillips Social Worker · Clinical 5110 Frederick Avenue, Baltimore, MD 21229 2012-12-18
1104179704 Shaunte Monet Hairston Technician, Pathology · Phlebotomy 1130 Cooks Ln, Baltimore, MD 21229 2012-10-19
Find all providers in zip 21229

Taxonomy Information

Taxonomy Code 207RA0401X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Addiction Medicine

Taxonomy Definition

An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: http://www.osteopathic.org/certification

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1326525973 Behavioral Health Leadership Institute, Inc 401 Edgar Street (van), Baltimore, MD 21202 2018-07-26
1760913297 Rek Advanced Therapeutic Solutions 6419 York Rd # A, Ste 100, Baltimore, MD 21212-2144 2017-03-26
1770575326 Howard Byron Cohen 6717 Park Heights Ave, Baltimore, MD 21215-2443 2005-08-19
1376801654 Aditi Ringwala 22 S Greene St, Baltimore, MD 21201-1544 2012-04-24
1174660930 Donald Robert Jasinski Sr. 5200 Eastern Ave, Mfl Bldg West Tower 2nd Floor, Baltimore, MD 21224-2734 2007-01-31
1962555292 Annie -- Umbricht 5510 Nathan Shock Dr, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224-6823 2007-01-19
1871566125 Michael Hayes 827 Linden Ave, Baltimore, MD 21201-4606 2006-02-08

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1619514049 Dundalk Medical Group 207 Wise Avenue, Dundalk, MD 21222-4911 2019-12-04
1326525973 Behavioral Health Leadership Institute, Inc 401 Edgar Street (van), Baltimore, MD 21202 2018-07-26
1760913297 Rek Advanced Therapeutic Solutions 6419 York Rd # A, Ste 100, Baltimore, MD 21212-2144 2017-03-26
1457604944 Justin Colin Everson Building 19h, Room 270, Perry Point Va Medical Center, Perry Point, MD 21902 2012-10-21
1033323795 Harry Calvin Stein 11140 Rockville Pike Ste 400, Rockville, MD 20852-3104 2007-05-10
1093738635 Nurul Amin Chowdhury 5721 Grosvenor Ln, Bethesda, MD 20814-1833 2006-07-25
1770575326 Howard Byron Cohen 6717 Park Heights Ave, Baltimore, MD 21215-2443 2005-08-19
1407402506 Mitchell Ira Burken · Mitchell Ira Burken 5716 Industry Ln, Frederick, MD 21704-5224 2019-08-14
1497161483 Chase Brexton Health Care · Chase Brexton Health Care 200 Hospital Drive, Suite 300, Glen Burnie, MD 21061-5877 2014-07-10
1376801654 Aditi Ringwala 22 S Greene St, Baltimore, MD 21201-1544 2012-04-24
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City BALTIMORE
Zip Code 21229

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.