MEDICARE: MULLIGAN RECOVERY CENTERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1972227957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MULLIGAN RECOVERY CENTERS

Provider Business Mailing Address
First Line	:	117 E MAIN ST
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-5012
Country	:	US
Telephone Number	:	443-463-7806
Fax Number	:

Provider Business Practice Location Address
First Line	:	117 E MAIN ST
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-5012
Country	:	US
Telephone Number	:	443-463-7806
Fax Number	:

Authorized Official
Title or Position	:	VP OF OPERATIONS
Name	:	HELEN MCCALL
Credential	:
Telephone Number	:	877-768-5544

Provider Enumeration Date	:	10/03/2022
Last Update Date	:	10/10/2022

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