Healthcare Provider Details

I. General information

NPI: 1710619515
Provider Name (Legal Business Name): ROSIE'S RECOVERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 E JOPPA RD STE 100
TOWSON MD
21286-1803
US

IV. Provider business mailing address

PO BOX 7844
ESSEX MD
21221-0844
US

V. Phone/Fax

Practice location:
  • Phone: 443-539-3001
  • Fax: 443-539-3020
Mailing address:
  • Phone: 443-539-3001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YOLANDA HAYES
Title or Position: OWNER
Credential:
Phone: 443-539-3001