Port Recovery Iop Inc.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

PORT RECOVERY IOP INC.

Practice address

7000 Harford Rd
Baltimore, MD 21234-7704

Phone

(443) 869-4909

Fax

(443) 869-4928

NPI assigned

Jun 8, 2012

Organization subpart

No

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

Authorized official

Name

Joanne Granruth

Title

Owner

Phone

(410) 534-8735

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555200000000",
    "number": "1588926216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8615 RIDGELYS CHOICE DR STE 205",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212363028",
            "telephone_number": "410-534-8735",
            "fax_number": "410-534-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 HARFORD RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212347704",
            "telephone_number": "443-869-4909",
            "fax_number": "443-869-4928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT RECOVERY IOP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-08",
        "last_updated": "2019-04-14",
        "status": "A",
        "authorized_official_last_name": "GRANRUTH",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-534-8735"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "680402100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kori Anahi Porosnicu Rodriguez, BA
• Jose Luis Porras Jr.
• Port Recovery Iop Inc.
• Port Recovery Iop Inc.
• Port Recovery Iop Inc.
• Port Recovery Iop Inc.
• Port Recovery Mental Health, Inc.
• Ava Port, M.D.
• Portal Health LLC
• Ashlae L Portell, PHD, LP

• Addiction (Substance Use Disorder) Counselor in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Addiction (Substance Use Disorder) Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2019; 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.