| Outreach Recovery Ii, Llc | |
|
30 W Gude Dr Ste 375 Rockville MD 20850-4300 | |
| (410) 800-4466 | |
| Not Available |
| Full Name | Outreach Recovery Ii, Llc |
|---|---|
| Speciality | Internal Medicine - Addiction Medicine |
| Location | 30 W Gude Dr Ste 375, Rockville, 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, Llc 4201 Northview Dr Ste 104 Bowie MD 20716-2655 Ph: (410) 800-4466 | Outreach Recovery Ii, Llc 30 W Gude Dr Ste 375 Rockville MD 20850-4300 Ph: (410) 800-4466 |
| NPI Number | 1386260990 |
|---|---|
| Provider Enumeration Date | 06/19/2020 |
| Last Update Date | 06/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386260990 | NPI | - | NPPES |
| 8249491676 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RA0401X | Internal Medicine - Addiction Medicine | (* (Not Available)) | Primary |
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