MEDICARE: REFINED LIFE SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1023733912
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REFINED LIFE SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	3412 MEADOWDALE DR
Second Line	:
City	:	WINDSOR MILL
State	:	MD
Zip	:	21244-2236
Country	:	US
Telephone Number	:	443-854-0113
Fax Number	:

Provider Business Practice Location Address
First Line	:	5504 DAYWALT AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21206-4405
Country	:	US
Telephone Number	:	443-854-0113
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TAMIKA NICOLE ASHE
Credential	:
Telephone Number	:	443-854-0113

Provider Enumeration Date	:	10/04/2022
Last Update Date	:	10/05/2022

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