Provider First Line Business Practice Location Address:
10 N. GREENE STREET (6C-139)
Provider Second Line Business Practice Location Address:
VAMHCS MENTAL HEALTH
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-605-7000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/11/2006