Provider Demographics
NPI:1649917022
Name:ELEMENTS RECOVERY LLC
Entity type:Organization
Organization Name:ELEMENTS RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:KUEHNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-961-1866
Mailing Address - Street 1:127 EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4354
Mailing Address - Country:US
Mailing Address - Phone:410-961-1866
Mailing Address - Fax:
Practice Address - Street 1:1424 BONSAL ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-5933
Practice Address - Country:US
Practice Address - Phone:410-961-1866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder