Active NPI
Cecil Community Recovery Center LLC
- Methadone Clinic
- Elkton, MD
National Provider Identifier
1093351678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Methadone Clinic
- Legal business name
- CECIL COMMUNITY RECOVERY CENTER LLC
- Practice address
- 409/411 W Pulaski Hwy
Elkton, MD 21921 - Phone
- (443) 904-3423
- NPI assigned
- Nov 19, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Anne Glazer
- Title
- Billing Manager
- Phone
- (443) 352-8622
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Methadone Clinic | 261QM2800X | Primary |
Addresses
Primary practice location
409/411 W Pulaski Hwy
Elkton, MD 21921
Mailing address
125 Slade Ave
Pikesville, MD 21208-4907
Phone (443) 352-8622
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Opioid treatment program
- Medicare-enrolled since Aug 9, 2022
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220322001522 | MD | Part B Supplier - Opioid Treatment Program (Otp) | 3173918562 | Practice locations: Elkton, MD |
National Provider Directory
National Provider Directory- Tax ID family
- Cecil Community Recovery Center LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Addiction (Substance Use Disorder) Counselor
- Elkton, MD
- NPI 1700627254
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Behavior Technician
- Owings Mills, MD
- NPI 1992379929
-
- Nurse Practitioner
- Historic New Castle, DE
- NPI 1275805335
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574121600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1706572800000",
"number": "1093351678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 SLADE AVE",
"city": "PIKESVILLE",
"state": "MD",
"postal_code": "212084907",
"telephone_number": "443-352-8622",
"fax_number": "443-450-3225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409/411 W PULASKI HWY",
"city": "ELKTON",
"state": "MD",
"postal_code": "21921",
"telephone_number": "443-904-3423"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CECIL COMMUNITY RECOVERY CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-11-19",
"last_updated": "2024-01-30",
"certification_date": "2021-10-27",
"status": "A",
"authorized_official_last_name": "GLAZER",
"authorized_official_first_name": "ANNE",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "443-352-8622"
},
"taxonomies": [
{
"code": "261QM2800X",
"taxonomy_group": "",
"desc": "Clinic/Center, Methadone",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.