Port Recovery Iop Inc.

LBN: Port Recovery Iop Inc.
Port Recovery Iop Inc. is an health care organization with primary practice located at 8615 Ridgelys Choice Dr Ste 205 , Nottingham MD 21236-3028. The organization recently has only one registered license in Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), which is considered as the primary health care specialty. Port Recovery Iop Inc. can be contacted via phone (443) 869-4909, or through Granruth, Joanne via phone (410) 534-8735.

Contact Information

Primary practice address
8615 Ridgelys Choice Dr Ste 205 Nottingham MD 21236-3028
Phone: (443) 869-4909
Fax: (443) 869-4928
Website:
Map and Directions
Authorized official contact:
Name: Granruth, Joanne
Phone: (410) 534-8735

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X

Profile Details

NPI number 1528522901
LBN Legal business name Port Recovery Iop Inc.
DBA Doing business as
Authorized official Granruth, Joanne
Entity Organization
Organization subpart 1 No
Enumeration date Jan 30th, 2019
Last updated Apr 14th, 2019 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528522901 NPPES
Maryland MEDICAID 907451100

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