Provider Demographics
NPI:1871996637
Name:TUERK HOUSE, INC.
Entity type:Organization
Organization Name:TUERK HOUSE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, MBA
Authorized Official - Phone:410-233-0684
Mailing Address - Street 1:730 NORTH ASHBURTON STREET
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21216
Mailing Address - Country:US
Mailing Address - Phone:410-233-0684
Mailing Address - Fax:410-233-8540
Practice Address - Street 1:2523 MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-4511
Practice Address - Country:US
Practice Address - Phone:410-233-0684
Practice Address - Fax:410-233-8540
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUERK HOUSE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD904879324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility