NPIMap

Organization Active NPI

Issiaih House 1

Doing business as Issaiah House 1

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1275019580
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
BH000372 Issued in MD
Legal business name
ISSIAIH HOUSE 1
Doing business as
Issaiah House 1
Practice address
2802 Harford Rd
Baltimore, MD 21218-4953
Phone
(443) 882-1943
Fax
(410) 558-6222
NPI assigned
Jul 19, 2018
Last updated
Jun 14, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
ISSAIAH HOUSEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Darryl Edward Braxton, LCPC, LCADCNPI 1558689323
Title
Director
Phone
(443) 882-1943

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X NU
Substance Abuse Rehabilitation Facility 324500000X BH000372 MD Primary

Addresses

Primary practice location

2802 Harford Rd
Baltimore, MD 21218-4953

Mailing address

919 Calwell Rd
Baltimore, MD 21229-5006
Phone (443) 882-1943

Other names 1

  • Issaiah House 1 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Issaiah House 1 Inc3 organizations share this tax ID, including this one
Part of
Issaiah House Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560470400000",
    "number": "1275019580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 CALWELL RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295006",
            "telephone_number": "443-882-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 HARFORD RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212184953",
            "telephone_number": "443-882-1943",
            "fax_number": "410-558-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISSIAIH HOUSE 1",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ISSAIAH HOUSE",
        "enumeration_date": "2018-07-19",
        "last_updated": "2019-06-14",
        "status": "A",
        "authorized_official_last_name": "BRAXTON",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-882-1943",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCPC, LCADC"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MD",
            "license": "BH000372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Issaiah House 1",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.