Provider Demographics
NPI:1235752064
Name:RECOVERY COALITION OF MARYLAND
Entity Type:Organization
Organization Name:RECOVERY COALITION OF MARYLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-831-9028
Mailing Address - Street 1:13619 DOVER CLIFFS PL
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-4656
Mailing Address - Country:US
Mailing Address - Phone:443-831-9028
Mailing Address - Fax:
Practice Address - Street 1:2900 HAMMONDS FERRY RD
Practice Address - Street 2:
Practice Address - City:HALETHORPE
Practice Address - State:MD
Practice Address - Zip Code:21227-3142
Practice Address - Country:US
Practice Address - Phone:301-750-4562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management