Healthcare Provider Details

I. General information

NPI: 1467121426
Provider Name (Legal Business Name): GLASS HOUSE RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2021
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8318 FORREST ST STE 100
ELLICOTT CITY MD
21043-5148
US

IV. Provider business mailing address

8318 FORREST ST STE 100
ELLICOTT CITY MD
21043-5148
US

V. Phone/Fax

Practice location:
  • Phone: 410-970-4842
  • Fax:
Mailing address:
  • Phone: 410-970-4842
  • Fax: 410-941-0156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER HALL GARBER
Title or Position: COO
Credential:
Phone: 410-970-4190