NPI 1366184244

Port Recovery Iop INC.

Organisation Psychiatric Residential Treatment Facility Baltimore, MD

Practice location

Address: 3202 Bayonne Ave, Baltimore, MD 21214-2325
Phone: (443) 869-4909
Fax: (443) 869-4928
Mailing address: 8615 Ridgelys Choice Dr STE 205, Nottingham, MD 21236-3028

Authorised official

Name: Joanne Granruth
Title: Owner
Phone: (443) 463-8035

Registered specialties

Psychiatric Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 323P00000X

Other Psychiatric Residential Treatment Facility providers in Maryland →

Registry record

NPI: 1366184244
Entity type: Organization
NPI issued: 11 Apr 2022
Record last updated: 11 Apr 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.