Healthcare Provider Details

I. General information

NPI: 1932671484
Provider Name (Legal Business Name): ABOVE ALL ODDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2018
Last Update Date: 12/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 E LEXINGTON ST STE 400
BALTIMORE MD
21202-1723
US

IV. Provider business mailing address

139 CARNELIARD CT
PIKESVILLE MD
21208-3342
US

V. Phone/Fax

Practice location:
  • Phone: 443-708-5699
  • Fax:
Mailing address:
  • Phone: 202-210-4962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. TURNER RASCOE III
Title or Position: CEO/ EXECUTIVE DIRECTOR
Credential:
Phone: 202-210-4962