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General NPI Number Information
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NPI Number | 1861265720
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Entity Type | Organization
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Legal Business Name | AMAZIN RECOVERY TREATMENT SERVICES LLC
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Dates
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Enumeration Date | 11/02/2023
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Last Update Date | 11/02/2023
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Provider Practice Location Address
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Address Line | 6730 HOLABIRD AVE STE 1
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City | DUNDALK
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State | MD
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Zip | 21222-1700
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Country | US
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Telephone | 443-376-5785
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Fax |
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Provider Business Mailing Address
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Address Line | 6730 HOLABIRD AVE STE 1
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City | DUNDALK
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State | MD
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Zip | 21222-1700
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Country | US
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Telephone | 443-376-5785
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAMELA C JOHNSON
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Credential | ADDITIONS COUNSELOR
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Telephone | 443-376-5785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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