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General NPI Number Information
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NPI Number | 1538976634
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Entity Type | Organization
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Legal Business Name | OUTREACH RECOVERY II, LLC
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 29466 PINTAIL DR STE 2
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City | EASTON
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State | MD
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Zip | 21601-9324
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Country | US
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Telephone | 667-280-7067
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Fax |
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Provider Business Mailing Address
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Address Line | 14205 PARK CENTER DR
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City | LAUREL
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State | MD
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Zip | 20707-5246
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF RCM
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Name | ANDREA MCDONALD
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Credential |
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Telephone | 443-365-2175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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