Michael's Loft Residential Program

Primary specialty

Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X

Legal business name

MICHAEL'S LOFT RESIDENTIAL PROGRAM

Practice address

743 Old Riverside Rd
Brooklyn Park, MD 21225-2660

Phone

(443) 388-9654

Fax

(443) 388-9367

NPI assigned

Sep 10, 2018

Last updated

Sep 10, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Aletta Pesi, LCPC

Title

Owner

Phone

(443) 416-5474

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536537600000",
    "number": "1326521089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N CHARLES ST STE 904",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015987",
            "telephone_number": "443-388-9654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 OLD RIVERSIDE RD",
            "city": "BROOKLYN PARK",
            "state": "MD",
            "postal_code": "212252660",
            "telephone_number": "443-388-9654",
            "fax_number": "443-388-9367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL'S LOFT RESIDENTIAL PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-10",
        "last_updated": "2018-09-10",
        "status": "A",
        "authorized_official_last_name": "PESI",
        "authorized_official_first_name": "ALETTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-416-5474",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Hospital Unit in Brooklyn Park, MD
• Providers in Brooklyn Park, MD by specialty
• Substance Use Disorder Rehabilitation Hospital Unit in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; 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.