MEDICARE: AMERICAN STANDARD HEALTH CARE INC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780355701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN STANDARD HEALTH CARE INC

Provider Business Mailing Address
First Line	:	5233 REISTERSTOWN RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-5018
Country	:	US
Telephone Number	:	443-682-7388
Fax Number	:

Provider Business Practice Location Address
First Line	:	5233 REISTERSTOWN RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-5018
Country	:	US
Telephone Number	:	443-682-7388
Fax Number	:	443-682-7388

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ABIOLA IKOTUN
Credential	:
Telephone Number	:	443-794-4339

Provider Enumeration Date	:	09/21/2021
Last Update Date	:	02/06/2025

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