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General NPI Number Information
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NPI Number | 1477498434
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Entity Type | Organization
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Legal Business Name | BISAK RESIDENTIAL RECOVERY SERVICES
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Dates
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Enumeration Date | 04/23/2026
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Last Update Date | 04/23/2026
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Provider Practice Location Address
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Address Line | 2115 WALBROOK AVE
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City | BALTIMORE
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State | MD
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Zip | 21217-1247
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Country | US
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Telephone | 443-231-3996
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Fax | 443-288-7001
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Provider Business Mailing Address
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Address Line | 218 E LEXINGTON ST
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City | BALTIMORE
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State | MD
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Zip | 21202-3532
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Country | US
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Telephone | 334-430-3333
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Fax | 443-288-7001
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Authorized Official
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Title or Position | CEO
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Name | MRS. FLORENCE BISI AKANBI
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Credential | APRN-PMHNP
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Telephone | 443-858-4111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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