| Outreach Recovery II | |
|
222 N Charles St Ste 101b Baltimore MD 21201-4032 | |
| (410) 800-4466 | |
| Not Available |
| Full Name | Outreach Recovery II |
|---|---|
| Speciality | Internal Medicine - Addiction Medicine |
| Location | 222 N Charles St Ste 101b, Baltimore, Maryland |
| Authorized Official Name and Position | Isiah Coles (COO) |
| Authorized Official Contact | 5615023978 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Outreach Recovery II 4201 Northview Dr Ste 104 Bowie MD 20716-2655 Ph: (410) 800-4466 | Outreach Recovery II 222 N Charles St Ste 101b Baltimore MD 21201-4032 Ph: (410) 800-4466 |
| NPI Number | 1346825486 |
|---|---|
| Provider Enumeration Date | 03/10/2021 |
| Last Update Date | 03/10/2021 |
| Certification Date | 03/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346825486 | NPI | - | NPPES |
| 100170888 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Secondary |
| 207RA0401X | Internal Medicine - Addiction Medicine | (NU) | Primary |
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