Provider Demographics
NPI:1205115508
Name:COVE RECOVERY, LLC FORMERLY J. DAVID COLLINS AND ASSOCIATES, LLC )
Entity type:Organization
Organization Name:COVE RECOVERY, LLC FORMERLY J. DAVID COLLINS AND ASSOCIATES, LLC )
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-548-3333
Mailing Address - Street 1:540 RIVERSIDE DRIVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-5352
Mailing Address - Country:US
Mailing Address - Phone:410-548-3333
Mailing Address - Fax:410-548-3341
Practice Address - Street 1:540 RIVERSIDE DRIVE
Practice Address - Street 2:SUITES 5 - 9
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5352
Practice Address - Country:US
Practice Address - Phone:410-548-3333
Practice Address - Fax:410-548-3341
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COVE RECOVERY, LLC-NEW NAME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-04
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
324500000X
MD904229103TA0400X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD555301600Medicaid