GRAPEVINE RECOVERY ASSOCIATES LLC (NPI# 1700313830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700313830 |
Entity Type | Organization |
Organization Name | GRAPEVINE RECOVERY ASSOCIATES LLC |
Other Organization Name | GRAPEVINE RECOVERY ASSOCIATES LLC |
Practice Address |
7580 Beach Dr Pasadena MD 21122-2508 |
Mailing Address |
2342 Monarch Terrace Dr Katy TX 77494-2626 |
Practice Telephone | 3017089671 |
Mailing Telephone | 3017089671 |
Enumeration Date | 2017-05-19 |
Last Update Date | 2017-05-19 |
Authorized Official Name | MR. KENNETH B SATROM (CEO) |
Authorized Official Telephone | 3017089671 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Grapevine Recovery Associates LLC | Former Legal Business Name - Organization |
Street Address |
7580 BEACH DR |
City | PASADENA |
State | MD |
Zip Code | 21122-2508 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740889211 | Hyunji Lee | Pharmacist | 8107 Governor Ritchie Highway, Pasadena, MD 21122 | 2020-10-25 |
1538712625 | Liri Fusha | Clinic/Center | 8221 Richie Hwy Suit #102, Pasadena, MD 21122 | 2019-07-18 |
1730649922 | Barrett Arthur Tollenger | Counselor | 2825 Mountain Road, Suite 204, Pasadena, MD 21122 | 2019-03-22 |
1750849543 | Bradley J Spoon | Counselor | 8028 Ritchie Highway St. 312, Pasadena, MD 21122 | 2019-03-11 |
1366916553 | Brittney Byrd | Behavior Technician | 7759 Middlegate Ct, Pasadena, MD 21122 | 2019-01-22 |
1780154310 | Amanda Ann Zeller | Speech-Language Pathologist | 8515 Jenkins Road, Pasadena, MD 21122 | 2018-11-27 |
1225531544 | Anne Arundel-sca Surgicenter, LLC | Clinic/Center | 8109 Ritchie Hwy Ste 250, Pasadena, MD 21122 | 2018-03-13 |
1629577424 | Anne Arundel Physician Group, LLC | Obstetrics & Gynecology | 18 Magothy Beach Road Suite A, Pasadena, MD 21122 | 2018-02-07 |
1063968261 | Chinedu Ikpemo | Pharmacist | 8051 Fort Smallwood Rd, Pasadena, MD 21122 | 2016-08-28 |
1053728634 | Wisecare, LLC | Clinic/Center | 33 Magothy Beach Rd, Suite 102-103, Pasadena, MD 21122 | 2014-07-16 |
Find all providers in zip 21122 |
Taxonomy Code | 261QR0405X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation, Substance Use Disorder |
Definition to come... |
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1437249869 | New Life Addiction Counseling Services Inc | Clinic/Center | 4231 Postal Ct, Suite 201, Pasadena, MD 21122-4439 | 2006-10-14 |
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1801403324 | Maryland Community Health Initiatives, Inc. | Clinic/Center | 328 E 26th St, Baltimore, MD 21218-4702 | 2020-09-29 |
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1598374407 | Sabinas House LLC | Clinic/Center | 605 Springfield Ave, Baltimore, MD 21212-4832 | 2020-07-27 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.