MEDICARE: RECOVERY180 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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1366137929
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RECOVERY180 LLC

Provider Business Mailing Address
First Line	:	1100 BUSINESS PKWY S STE 1
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-3048
Country	:	US
Telephone Number	:	443-204-5800
Fax Number	:

Provider Business Practice Location Address
First Line	:	22119 ROYAL OAK RD
Second Line	:
City	:	QUANTICO
State	:	MD
Zip	:	21856-2084
Country	:	US
Telephone Number	:	443-289-8606
Fax Number	:

Authorized Official
Title or Position	:	COMPLIANCE
Name	:	DESIREE MOUNTAIN
Credential	:
Telephone Number	:	443-204-5800

Provider Enumeration Date	:	04/10/2023
Last Update Date	:	04/10/2023

Similar Medicare Providers

1215198684 — JOYCE PHILLIPS
Practice Location Address:

12026 MASON DR
QUANTICO, VA
22134-2084

Practice Phone: 703-842-7984
Practice Fax:

1275203275 — ADDICTION WELLNESS CENTER LLC
Practice Location Address:

5438 SANDY HILL RD STE A
QUANTICO, MD
21856-2100

Practice Phone: 443-547-2964
Practice Fax:

1427787944 — RECOVERY180 LLC
Practice Location Address:

5438 SANDY HILL RD
QUANTICO, MD
21856-2100

Practice Phone: 443-204-5800
Practice Fax:

1598470288 — GEORGIA HANDY CSC-AD
Practice Location Address:

5438 SANDY HILL RD
QUANTICO, MD
21856-2100

Practice Phone: 240-681-9654
Practice Fax:

1205518974 — MICHAEL DYER SR. LMSW
Practice Location Address:

5277 GREEN HILL CIR
QUANTICO, MD
21856-2053

Practice Phone: 410-430-2517
Practice Fax:

1912760877 — ADDICTION WELLNESS CENTER LLC
Practice Location Address:

5438 SANDY HILL RD STE A
QUANTICO, MD
21856-2100

Practice Phone: 443-547-2964
Practice Fax:

Directions to “RECOVERY180 LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.