| Port Recovery Iop Inc. | |
|
8615 Ridgelys Choice Dr Ste 205 Nottingham MD 21236-3028 | |
| (443) 869-4909 | |
| (443) 869-4928 |
| Full Name | Port Recovery Iop Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 8615 Ridgelys Choice Dr Ste 205, Nottingham, Maryland |
| Authorized Official Name and Position | Joanne Granruth (OWNER) |
| Authorized Official Contact | 4434638035 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Recovery Iop Inc. 8615 Ridgelys Choice Dr Ste 205 Nottingham MD 21236-3028 Ph: (443) 869-4909 | Port Recovery Iop Inc. 8615 Ridgelys Choice Dr Ste 205 Nottingham MD 21236-3028 Ph: (443) 869-4909 |
| NPI Number | 1518609585 |
|---|---|
| Provider Enumeration Date | 04/11/2022 |
| Last Update Date | 04/11/2022 |
| Certification Date | 04/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518609585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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