MEDICARE: RODNEY VAUGHN

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	:	1497619167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODNEY VAUGHN

Provider Business Mailing Address
First Line	:	250 AMERICAN WAY APT 517
Second Line	:
City	:	OXON HILL
State	:	MD
Zip	:	20745-4534
Country	:	US
Telephone Number	:	202-568-0792
Fax Number	:

Provider Business Practice Location Address
First Line	:	5021 EMO ST
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-2861
Country	:	US
Telephone Number	:	202-568-0792
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/18/2025

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Directions to “ RODNEY VAUGHN ” Practice Location

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