Grapevine Recovery Associates LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

GRAPEVINE RECOVERY ASSOCIATES LLC

Practice address

7580 Beach Dr
Pasadena, MD 21122-2508

Phone

(301) 708-9671

NPI assigned

May 19, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth B Satrom

Title

Ceo

Phone

(301) 708-9671

Specialties & licenses 1

Addresses

Other names 1

• Grapevine Recovery Associates LLC Former legal business name

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

{
    "created_epoch": "1495152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495152000000",
    "number": "1700313830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2342 MONARCH TERRACE DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774942626",
            "telephone_number": "301-708-9671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 BEACH DR",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211222508",
            "telephone_number": "301-708-9671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAPEVINE RECOVERY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-19",
        "last_updated": "2017-05-19",
        "status": "A",
        "authorized_official_last_name": "SATROM",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-708-9671",
        "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": "Grapevine Recovery Associates LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Michael Goodman, MS, LAT, ATC
• Kyle Goodwin, DPT
• Sarah Goranson
• Ira J Gottlieb, D.P.M.
• Brielle Alexis Gourley, LGPC
• Jeffrey Howard Greenstein, DDS
• Dominique Rachelle Griffin, PA-C
• Samuel Alexander Griffith, CRNP
• Timothy Wayne Griffith, LCSW
• Amanda K Griggs

• Substance Use Disorder Rehabilitation Clinic/Center in Pasadena, MD
• Providers in Pasadena, 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 May 19, 2017; 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.