Provider Demographics
NPI:1891239190
Name:ARI MENTAL HEALTH GROUP PRACTISE
Entity Type:Organization
Organization Name:ARI MENTAL HEALTH GROUP PRACTISE
Other - Org Name:ADDICTION RECOVERY, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CREDENTIALING/BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MACCHIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-299-1554
Mailing Address - Street 1:26 MARBURY DR
Mailing Address - Street 2:
Mailing Address - City:CROWNSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21032-2065
Mailing Address - Country:US
Mailing Address - Phone:410-923-6700
Mailing Address - Fax:410-923-6213
Practice Address - Street 1:26 MARBURY DR
Practice Address - Street 2:
Practice Address - City:CROWNSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21032-2065
Practice Address - Country:US
Practice Address - Phone:410-923-6700
Practice Address - Fax:410-923-6213
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOPE HOUSE TREATMENT CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-06
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD590503600Medicaid
MD905494OtherSTATE LICENSE