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Contact Information

OUTREACH RECOVERY II, LLC
11340 PEMBROOKE SQ STE 214
WALDORF, MD20603-4808
 Phone: 410-800-4466
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Medicine

2083A0300X 84 Physician/Preventive Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Psychiatric/Mental Health, Adult

364SP0809X 89 Certified Clinical Nurse Specialist
Indicates primary specialty

NPI Profile & details for OUTREACH RECOVERY II, LLC

NPI Number 1801452362
LBN Legal business name OUTREACH RECOVERY II, LLC
Authorized official ISIAH COLES - (COO)
Entity Organization
Organization subpart 1 No
Enumeration date 05/10/2019
Last updated 07/31/2024 - More than a year ago
Identifiers
MD Medicaid 777797300
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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