NPIMap

Organization Active NPI

Innersourced Solutions Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Waldorf, MD
National Provider Identifier
1144917410
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
INNERSOURCED SOLUTIONS INC
Practice address
11705 Berry Rd Ste 104
Waldorf, MD 20603-5933
Phone
(240) 207-4513
NPI assigned
Apr 18, 2023
Organization subpart
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michelle A Dillard
Title
Ceo
Phone
(240) 207-4513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

11705 Berry Rd Ste 104
Waldorf, MD 20603-5933

Mailing address

11705 Berry Rd Ste 104
Waldorf, MD 20603-5933
Phone (240) 207-4513

National Provider Directory

National Provider Directory
Tax ID family
Innersourced Solutions Inc6 organizations share this tax ID, including this one
Part of
Innersourced Solutions Inc

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11705 Berry Rd
Ste 104
Waldorf, MD 20603
Phone (240) 207-4513

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1144917410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11705 BERRY RD STE 104",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206035933",
            "telephone_number": "240-207-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11705 BERRY RD STE 104",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206035933",
            "telephone_number": "240-207-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNERSOURCED SOLUTIONS INC",
        "organizational_subpart": "YES",
        "enumeration_date": "2023-04-18",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "DILLARD",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-207-4513"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.