Organization
OUTREACH RECOVERY II, LLC
Active
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
134 BALTIMORE ST, CUMBERLAND, MD 21502-2302
(877) 889-4829
Mailing address
14205 PARK CENTER DR, LAUREL, MD 20707-5246
(410) 800-4466
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
—
—
207Q00000X
Family Medicine Physician
—
—
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
—
—
Other
Enumeration date
05/10/2019
Last updated
12/01/2023
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