| Organization Name: | JOPPA HEALTH SERVICES, INC. |
| NPI Number: | 1619026432 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRENT GARRETT BOWMAN (ADMINISTRATIVE DIRECTOR) |
| Mailing Address: | 623 Pulaski Hwy # A Joppa |
| State: | MD US |
| Postal Code: | 210853914 |
| Phone Number: | 4105385809 |
| Fax Number: | 4105384249 |
| NPI Enumeration Date: | 01/10/2007 |
| NPI Last Update Date: | 10/24/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM2800X |
| License Number: | 11026 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Methadone Clinic |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |