=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487559696
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LUMOS RECOVERY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/09/2026
-----------------------------------------------------
Last Update Date | 10/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 215 SCHILLING CIR STE 103
-----------------------------------------------------
City | HUNT VALLEY
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21031-1112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-500-1111
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 124 GROVE AVE UNIT 339
-----------------------------------------------------
City | CEDARHURST
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11516-4014
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-516-1793
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | LAWRENCE WEISS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 717-516-1793
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QR0405X
-----------------------------------------------------
Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------