Idas Place LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

IDAS PLACE LLC

Practice address

583 Frederick Rd Ste 3a
Catonsville, MD 21228-4697

Phone

(443) 710-3061

Fax

(410) 747-5001

NPI assigned

Mar 13, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Dominique E Liverpool

Title

President

Phone

(443) 710-3061

Specialties & licenses 1

Addresses

Other names 1

• Transitioning and Uplifting Inc Other name

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1194583146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "583 FREDERICK RD STE 3A",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212284697",
            "telephone_number": "443-710-3061",
            "fax_number": "410-747-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "583 FREDERICK RD STE 3A",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212284697",
            "telephone_number": "443-710-3061",
            "fax_number": "410-747-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAS PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "LIVERPOOL",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "443-710-3061",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Transitioning and Uplifting Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Natalie C Hung, PHD
• Kathryn G Hunt, LCSW-C
• Carol Dianne Hunte, NP
• Hyung Joon Kim DDS PC
• Timothy Murungi Ibutu, LCPC, NCC
• Ideal Healthcare Solutions, LLC
• Ideal Option, PLLC
• Ideal Telemedicine Services, LLC
• Ejemeare P Igene, O.D
• Pauline Chinwe Igwe, HHA

• Substance Use Disorder Rehabilitation Clinic/Center in Catonsville, MD
• Providers in Catonsville, MD by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.