Organization
PORT RECOVERY IOP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW FINLEY (PROGRAM DIRECTOR)
(443) 869-4909
Entity
Organization
Contact information
Practice address
2917 BAYONNE AVE, BALTIMORE, MD 21214-1726
(443) 869-4909
(443) 869-4928
Mailing address
8615 RIDGELYS CHOICE DR STE 205, NOTTINGHAM, MD 21236-3028
(434) 869-4909
(443) 869-4928
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6800271
—
MD
05
—
6800297
—
MD
05
—
6804021
—
MD
Enumeration date
10/26/2023
Last updated
10/26/2023
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