Healthcare Provider Details

I. General information

NPI: 1184447203
Provider Name (Legal Business Name): OSHIN AMOR RECOVERY CENTER L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2024
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 GARRISON BLVD STE 250
BALTIMORE MD
21216-2377
US

IV. Provider business mailing address

4501 ELI DR APT E
OWINGS MILLS MD
21117-3798
US

V. Phone/Fax

Practice location:
  • Phone: 443-760-1479
  • Fax:
Mailing address:
  • Phone: 443-760-1479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: NAKIA N WILLIAMS
Title or Position: OWNER
Credential: RN
Phone: 443-760-1479