NPIMap

Organization Active NPI

Powell Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1497984645
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
903742 Issued in MD
Legal business name
POWELL RECOVERY CENTER
Practice address
14 S Broadway
Baltimore, MD 21231-1712
Phone
(410) 276-1773
Fax
(410) 276-2056
NPI assigned
Jul 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Faythe Moyer
Title
Billing Director
Phone
(410) 276-1773

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 903742 MD Primary

Addresses

Primary practice location

14 S Broadway
Baltimore, MD 21231-1712

Mailing address

14 S Broadway
Baltimore, MD 21231-1712
Phone (410) 276-1773

Other identifiers 1

IdentifierTypeStateIssuer
6355102-00MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Powell Recovery Center58 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1247097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1497984645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 S BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212311712",
            "telephone_number": "410-276-1773",
            "fax_number": "410-276-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 S BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212311712",
            "telephone_number": "410-276-1773",
            "fax_number": "410-276-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWELL RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-09",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MOYER",
        "authorized_official_first_name": "FAYTHE",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "410-276-1773"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MD",
            "license": "903742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6355102-00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.