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BALTIMORE DETOX CENTER LLC
NPI 1275115495
Substance Abuse Rehabilitation Facility in Woodlawn, MD

Active since April 27, 2021CLIA 21D2283011 · Waiver
1825 WOODLAWN DR, WOODLAWN, MD 21207(410) 457-7396 Get Directions Write a Review

NPPES record last updated: January 12, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jan 5, 2024, Nov 17, 2023, Jan 10, 2023 and 1 more (4 updates tracked since 2021).

About Baltimore Detox Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BALTIMORE DETOX CENTER LLC (NPI 1275115495) is a healthcare organization registered as a substance abuse rehabilitation facility in Woodlawn, Maryland and active in the NPI registry since April 2021. The organization holds a CLIA Waiver certificate valid through May 30, 2027 and lists Allison Heaberlin, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1275115495
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameBALTIMORE DETOX CENTER LLC
Location Address1825 WOODLAWN DRWoodlawn, MD 21207-4080
Mailing Address10461 Mill Run Cir Ste 810Owings Mills, MD 21117-5549
Phone(410) 457-7396
Organization SubpartNo
Authorized OfficialAllison HeaberlinCredentialing Specialist · (410) 415-3385
Enumeration DateApril 27, 2021
Last NPPES UpdateJanuary 12, 20244 updates tracked since enumeration
NPPES CertifiedJanuary 12, 2024
✔ NPI 1275115495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
1825 WOODLAWN DR, Woodlawn, MD 21207
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Other Identifiers 1

Medicaid882570000MD

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D2283011

Baltimore Detox Center LLC · Woodlawn, MD
Active · expires May 30, 2027
CLIA Number21D2283011
Laboratory TypeScreen Ua
Certificate Effective DateMay 31, 2025
Certificate Expiration DateMay 30, 2027
Laboratory DirectorJeanette Mitchell
Laboratory Phone(301) 991-9718
Laboratory LocationBaltimore Detox Center LLC1825 Woodlawn Drive, Woodlawn, MD 21207
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRIDGET D SCHILLING
Counselor (Addiction (Substance Use Disorder))
1825 WOODLAWN DR
WOODLAWN, MD 21207
Baltimore City (410) 401-1970
MITCHELL SCOTT DAHNE
Counselor (Addiction (Substance Use Disorder))
1825 WOODLAWN DR
BALTIMORE, MD 21207
Baltimore City (410) 401-1970
ERIN MELLETT HENDRIX
Counselor (Addiction (Substance Use Disorder))
1825 WOODLAWN DR
BALTIMORE, MD 21207
Baltimore City (410) 401-1970
ANDREA VIRGINIA CARTER
Registered Nurse
1825 WOODLAWN DR
WOODLAWN, MD 21207
Baltimore City (443) 429-8152
PRIYA HELLSTROM
Social Worker
1825 WOODLAWN DR
WOODLAWN, MD 21207
Baltimore City (410) 401-1970
KORTNEY BRYANNA FOSTER LGPC
Counselor (Professional)
1825 WOODLAWN DR
WOODLAWN, MD 21207
Baltimore City (410) 401-1970
ANGALENE SIMS
Licensed Practical Nurse
1825 WOODLAWN DR
WOODLAWN, MD 21207
Baltimore City (443) 429-8152

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Baltimore Detox Center LLC's NPI number?

The NPI number for Baltimore Detox Center LLC is 1275115495. It was assigned to this organization in the NPPES registry on April 27, 2021.

Where is Baltimore Detox Center LLC located?

Baltimore Detox Center LLC is located at 1825 Woodlawn Dr, Woodlawn, MD 21207. The listed phone number is (410) 457-7396.

What is Baltimore Detox Center LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Baltimore Detox Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2283011) is associated with this NPI, valid through May 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Baltimore Detox Center LLC was last updated on January 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.