| Outreach Recovery Ii | |
|
110 Hospital Rd Ste 306 Prince Frederick MD 20678-4046 | |
| (410) 800-4466 | |
| Not Available |
| Full Name | Outreach Recovery Ii |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 110 Hospital Rd Ste 306, Prince Frederick, Maryland |
| Authorized Official Name and Position | Ginny Hayden (LICENSING MANAGER) |
| Authorized Official Contact | 2407285864 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Outreach Recovery Ii 14205 Park Center Dr # 201202 Laurel MD 20707-5246 Ph: (410) 800-4466 | Outreach Recovery Ii 110 Hospital Rd Ste 306 Prince Frederick MD 20678-4046 Ph: (410) 800-4466 |
| NPI Number | 1871257964 |
|---|---|
| Provider Enumeration Date | 10/26/2021 |
| Last Update Date | 07/31/2024 |
| Certification Date | 07/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871257964 | NPI | - | NPPES |
| 77779730 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
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