Provider Demographics
NPI:1881006294
Name:RECOVERY FOR LIFE, INC.
Entity Type:Organization
Organization Name:RECOVERY FOR LIFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM SPONSOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:SALVATORE
Authorized Official - Last Name:SPATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-276-2212
Mailing Address - Street 1:3719 E BALTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-1509
Mailing Address - Country:US
Mailing Address - Phone:410-276-2212
Mailing Address - Fax:410-814-0434
Practice Address - Street 1:3719 E BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-1509
Practice Address - Country:US
Practice Address - Phone:410-276-2212
Practice Address - Fax:410-814-0434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3785101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty