# OUTREACH RECOVERY II, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427541838
- **Authorized official:** ISIAH COLES (COO)
- **Authorized official phone:** (561) 502-3978

## Contact information

- **Practice address:** 14205 PARK CENTER DR \# 201202, LAUREL, MD 20707-5246
- **Practice address phone:** (410) 800-4466
- **Mailing address:** 14205 PARK CENTER DR \# 201202, LAUREL, MD 20707-5246
- **Mailing address phone:** (410) 800-4466
- **Mailing address fax:** (410) 705-5024

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | Yes |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | NULL | — |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | — | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |

## Other

- **Enumeration date:** 06/11/2018
- **Last updated:** 02/18/2025