Active NPI
Bel Air Recovery Center, LLC
- Methadone Clinic
- Bel Air, MD
National Provider Identifier
1790325645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Methadone Clinic
- Legal business name
- BEL AIR RECOVERY CENTER, LLC
- Practice address
- 2014 S Tollgate Rd Ste 106
Bel Air, MD 21015-5906 - Phone
- (443) 402-0612
- Fax
- (443) 402-1381
- NPI assigned
- Jan 8, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Kratz Jr.
- Title
- Cfo
- Phone
- (410) 925-3514
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Methadone Clinic | 261QM2800X | Primary |
Addresses
Primary practice location
2014 S Tollgate Rd Ste 106
Bel Air, MD 21015-5906
Mailing address
1344 Goose Neck Rd
Middle River, MD 21220-4027
Phone (410) 925-3514
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Opioid treatment program
- Medicare-enrolled since Dec 3, 2022
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210112002813 | MD | Part B Supplier - Opioid Treatment Program (Otp) | 9931536281 | Practice locations: Bel Air, MD |
National Provider Directory
National Provider Directory- Tax ID family
- Bel Air Recovery Center LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Methadone Clinic
- Bel Air, MD
- NPI 1396300398
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Havre de Grace, MD
- NPI 1831225606
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578441600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1578441600000",
"number": "1790325645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1344 GOOSE NECK RD",
"city": "MIDDLE RIVER",
"state": "MD",
"postal_code": "212204027",
"telephone_number": "410-925-3514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2014 S TOLLGATE RD STE 106",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210155906",
"telephone_number": "443-402-0612",
"fax_number": "443-402-1381"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BEL AIR RECOVERY CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-01-08",
"last_updated": "2020-01-08",
"certification_date": "2020-01-08",
"status": "A",
"authorized_official_last_name": "KRATZ",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "410-925-3514",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "261QM2800X",
"taxonomy_group": "",
"desc": "Clinic/Center, Methadone",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bel Air, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.