Healthcare Provider Details

I. General information

NPI: 1255957296
Provider Name (Legal Business Name): ONE MORE CHANCE RECOVERY II LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3413A DUNDALK AVE
BALTIMORE MD
21222-5921
US

IV. Provider business mailing address

3413A DUNDALK AVE
DUNDALK MD
21222-5921
US

V. Phone/Fax

Practice location:
  • Phone: 443-503-5096
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. DENISE TAYLOR
Title or Position: CEO
Credential: MSM, MBA
Phone: 410-622-2170