4 Walls Health Services Inc.

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

4 WALLS HEALTH SERVICES INC.

Practice address

6609 Reisterstown Rd
Suite 104
Baltimore, MD 21215-2315

Phone

(443) 762-6949

NPI assigned

Oct 9, 2008

Organization subpart

No

Name

Mrs. Pamela Andrea Gibson-Jones, CAC-AD

Title

Clinical Director

Phone

(443) 762-6949

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 9, 2008.

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1407007289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6609 REISTERSTOWN RD",
            "address_2": "SUITE 104",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212152315",
            "telephone_number": "443-762-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6609 REISTERSTOWN RD",
            "address_2": "SUITE 104",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212152315",
            "telephone_number": "443-762-6949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4 WALLS HEALTH SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-09",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "GIBSON-JONES",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "ANDREA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "443-762-6949",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CAC-AD"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 360 Rehabilitation & Chiropractic LLC
• 360 Therapy Group LLC
• 4 2 Restore Drug & Alcohol Recovery Center
• 4 2 Restore LLC
• 4 Evergreen Recovery Homes and Services
• 444 Logistics LLC
• 6000 Bellona Avenue Operations LLC
• 6000 Bellona Avenue Operations LLC
• 6000 Bellona Opco LLC
• 6040 Harford Road Operations LLC

• All providers in Baltimore, MD
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; 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.