Organization
OUTREACH RECOVERY II, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISIAH COLES (COO)
(561) 502-3978
Entity
Organization
Contact information
Practice address
30 W GUDE DR STE 375, ROCKVILLE, MD 20850-4300
(410) 800-4466
Mailing address
4201 NORTHVIEW DR STE 104, BOWIE, MD 20716-2655
(410) 800-4466
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8249491676
—
MD
Enumeration date
06/19/2020
Last updated
06/19/2020
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