Outreach Recovery Ii | |
716 Maiden Choice Ln Ste 302 Catonsville MD 21228-5960 | |
(410) 800-4466 | |
Not Available |
Full Name | Outreach Recovery Ii |
---|---|
Speciality | Internal Medicine - Addiction Medicine |
Location | 716 Maiden Choice Ln Ste 302, Catonsville, Maryland |
Authorized Official Name and Position | Isiah Coles (COO) |
Authorized Official Contact | 5615023978 |
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 716 Maiden Choice Ln Ste 302 Catonsville MD 21228-5960 Ph: (410) 800-4466 |
NPI Number | 1417532433 |
---|---|
Provider Enumeration Date | 03/11/2021 |
Last Update Date | 07/31/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417532433 | NPI | - | NPPES |
100170888 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
207RA0401X | Internal Medicine - Addiction Medicine | (* (Not Available)) | Primary |
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