| Rosie's Recovery Center, Llc | |
|
8109 Harford Rd Ste B Parkville MD 21234-9205 | |
| (443) 539-3001 | |
| (443) 539-3020 |
| Full Name | Rosie's Recovery Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8109 Harford Rd Ste B, Parkville, Maryland |
| Authorized Official Name and Position | Yolanda Hayes (OWNER) |
| Authorized Official Contact | 4435393001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rosie's Recovery Center, Llc Po Box 7844 Essex MD 21221-0844 Ph: (443) 539-3001 | Rosie's Recovery Center, Llc 8109 Harford Rd Ste B Parkville MD 21234-9205 Ph: (443) 539-3001 |
| NPI Number | 1205573946 |
|---|---|
| Provider Enumeration Date | 05/15/2022 |
| Last Update Date | 09/26/2022 |
| Certification Date | 09/26/2022 |
| Medicare PECOS PAC ID | 5597147405 |
|---|---|
| Medicare Enrollment ID | O20220809000350 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205573946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Immaculata M Ulu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740298579 PECOS PAC ID: 2860491834 Enrollment ID: I20061220000556 |
| Provider Name | Camillia Whitehead |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497296909 PECOS PAC ID: 8527328723 Enrollment ID: I20180208001209 |
| Provider Name | Ifeoma J Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811527278 PECOS PAC ID: 6800225079 Enrollment ID: I20200409001463 |
| Provider Name | Vivien Mary Buvawala |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366095952 PECOS PAC ID: 6103284609 Enrollment ID: I20230615000394 |
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