Organization
SPARKS RECOVERY NETWORK, LLC
Active
Organization
SPARKS RECOVERY NETWORK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BITALO ISAAC (CEO/FOUNDER)
(443) 783-2712
Entity
Organization
Contact information
Practice address
218 E LEXINGTON ST STE 501, BALTIMORE, MD 21202-3531
(443) 712-6672
Mailing address
218 E LEXINGTON ST STE 501, BALTIMORE, MD 21202-3531
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/01/2022
Last updated
06/24/2022
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