Healthcare Provider Details

I. General information

NPI: 1639091416
Provider Name (Legal Business Name): ONE MORE CHANCE RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3413 DUNDALK AVE STE B
BALTIMORE MD
21222-5921
US

IV. Provider business mailing address

3413 DUNDALK AVE STE B
BALTIMORE MD
21222-5921
US

V. Phone/Fax

Practice location:
  • Phone: 443-503-3096
  • Fax:
Mailing address:
  • Phone: 443-503-3096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: DENISE D TAYLOR
Title or Position: CEO
Credential:
Phone: 404-819-2310