Healthcare Provider Details

I. General information

NPI: 1871116541
Provider Name (Legal Business Name): RECOVERY CENTER OF PENNSLYVANIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2020
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7909 PULASKI HWY
ROSEDALE MD
21237-2713
US

IV. Provider business mailing address

7909 PULASKI HWY
ROSEDALE MD
21237-2713
US

V. Phone/Fax

Practice location:
  • Phone: 704-901-4916
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. WARRICK TREMAYNE STEWART
Title or Position: CEO
Credential:
Phone: 704-901-4916