MEDICARE: POWELL RECOVERY CENTER

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	:	1578042198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POWELL RECOVERY CENTER

Provider Business Mailing Address
First Line	:	14 S BROADWAY
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21231-1712
Country	:	US
Telephone Number	:	443-974-3027
Fax Number	:

Provider Business Practice Location Address
First Line	:	3036 GWYNNS FALLS PKWY
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21216-2720
Country	:	US
Telephone Number	:	443-974-3027
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT BILLING
Name	:	FAYTHE JOHNSON
Credential	:	LCSW-C
Telephone Number	:	443-974-3027

Provider Enumeration Date	:	08/14/2018
Last Update Date	:	08/14/2018

Similar Medicare Providers

1306325923 — POWELL RECOVERY CENTER
Practice Location Address:

3038 GWYNNS FALLS PKWY
BALTIMORE, MD
21216-2720

Practice Phone: 410-276-1773
Practice Fax:

1043922024 — NEW INSIGHTS BEHAVIORAL HEALTH
Practice Location Address:

2720 W NORTH AVE STE 255
BALTIMORE, MD
21216-3138

Practice Phone: 410-449-5129
Practice Fax:

1407960032 — STEVEN ALLEN BLACKWELL PH.D., J.D., R.PH.
Practice Location Address:

7500 SECURITY BLVD # C3-20-17 , CENTERS FOR MEDICARE & MEDICAID SERVICES
BALTIMORE, MD
21244-1849

Practice Phone: 410-786-6852
Practice Fax:

1396961561 — DR. MARSHA SMITH MD
Practice Location Address:

7500 SECURITY BOULEVARD , CENTERS FOR MEDICARE & MEDICAID SERVICES
BALTIMORE, MD
21201-2301

Practice Phone: 410-786-6614
Practice Fax:

1134335441 — JULIE DAWN PREIS
Practice Location Address:

7500 SECURITY BLVD MS C1-13-07 , CENTERS FOR MEDICARE & MEDICAID SERVICES
BALTIMORE, MD
21244

Practice Phone: 410-786-0525
Practice Fax:

1841726213 — ASHLEY JACOBS
Practice Location Address:

4224 SLATER AVE
BALTIMORE, MD
21236-2720

Practice Phone: 410-527-1274
Practice Fax:

Directions to “POWELL RECOVERY CENTER ” 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 © 2007-2025 (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.