NPIMap

Organization Active NPI

Innersourced Solutions, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Baltimore, MD
National Provider Identifier
1700624053
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
INNERSOURCED SOLUTIONS, INC.
Practice address
3455 Wilkens Ave Ste 209
Baltimore, MD 21229-5265
Phone
(442) 639-4930
NPI assigned
Jul 19, 2024
Last updated
Jul 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Authorized official

Name
Dr. Michelle A Dillard, DSWNPI 1083988133
Title
Ceo
Phone
(240) 207-4513

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

3455 Wilkens Ave Ste 209
Baltimore, MD 21229-5265

Mailing address

11705 Berry Rd Ste 104
Waldorf, MD 20603-5933

National Provider Directory

National Provider Directory
Tax ID family
Innersourced Solutions Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1700624053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11705 BERRY RD STE 104",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206035933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 WILKENS AVE STE 209",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295265",
            "telephone_number": "442-639-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNERSOURCED SOLUTIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "DILLARD",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-207-4513",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DSW"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 19, 2024; 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.