Healthcare Provider Details

I. General information

NPI: 1750005781
Provider Name (Legal Business Name): RAM RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2022
Last Update Date: 11/04/2022
Certification Date: 11/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3649 LEONARDTOWN RD
WALDORF MD
20601-3626
US

IV. Provider business mailing address

3455 WILKENS AVE STE 203
BALTIMORE MD
21229-5265
US

V. Phone/Fax

Practice location:
  • Phone: 410-401-0297
  • Fax:
Mailing address:
  • Phone: 410-401-0297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMEELA MITCHELL
Title or Position: NURSE PRACTITIONER
Credential: CRNP
Phone: 443-300-6757