Healthcare Provider Details

I. General information

NPI: 1871434035
Provider Name (Legal Business Name): R.A BURRELL ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2308 WHITTIER AVE APT B
BALTIMORE MD
21217-5280
US

IV. Provider business mailing address

10 E NORTH AVE STE 5
BALTIMORE MD
21202-4886
US

V. Phone/Fax

Practice location:
  • Phone: 410-814-8956
  • Fax:
Mailing address:
  • Phone: 410-814-8956
  • 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: RASHEEAH AMEERAH BURRELL
Title or Position: OWNER/PROGRAM DIRECTOR
Credential: BURRELL
Phone: 410-814-8956