# PORT RECOVERY MENTAL HEALTH, INC.

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

## Provider details

- **NPI number:** 1932453727
- **Authorized official:** JOANNE GRANRUTH (OWNER)
- **Authorized official phone:** (443) 534-8735

## Contact information

- **Practice address:** 7004 HARFORD RD, BALTIMORE, MD 21234-7704
- **Practice address phone:** (443) 869-4909
- **Practice address fax:** (443) 869-4928
- **Mailing address:** 8615 RIDGELYS CHOICE DR STE 205, NOTTINGHAM, MD 21236-3028
- **Mailing address phone:** (410) 534-8735
- **Mailing address fax:** (410) 534-8737

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 11/01/2012
- **Last updated:** 11/19/2018