SECONDCHANCE RECOVERY HOUSE LLC (NPI# 1023537800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023537800 |
| Entity Type | Organization |
| Organization Name | SECONDCHANCE RECOVERY HOUSE LLC |
| Other Organization Name | REBIRTH ENHANCEMENT SERVICES |
| Practice Address |
1410 Crain Hwy N Ste 5b Glen Burnie MD 21061-9304 |
| Practice Telephone | 4432672844 |
| Practice Fax Number | 8664509832 |
| Mailing Telephone | 4432672844 |
| Mailing Fax Number | 8664509832 |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2019-01-16 |
| Authorized Official Name | MRS. LITRA L SIMMS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4432672844 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0800X |
Clinic/Center Specialization: Recovery Care |
Ambulatory Health Care Facilities | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Rebirth Enhancement Services | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1207 Aster Dr, Glen Burnie, MD 210612916 | (410) 903-8710 | 8664509832 |
| Street Address |
1410 CRAIN HWY N STE 5B |
| City | GLEN BURNIE |
| State | MD |
| Zip Code | 21061-9304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538400775 | James Steffan Collins IIi | Counselor | 1410 Crain Hwy N Ste 5b, Glen Burnie, MD 21061-9304 | 2013-03-13 |
| 1346747029 | Second Chance Recovery House LLC | Substance Abuse Rehabilitation Facility | 1410 Crain Hwy N Ste 5b, Glen Burnie, MD 21061-9304 | 2018-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255814422 | Lotus Behavioral Health and Rehabilitation Services Inc. | Behavior Technician | 6426 Harrison Square, Glen Burnie, MD 21061 | 2018-09-12 |
| 1942795315 | Tina Brown | Behavior Technician | Rise for Autism, 510 Mccormick Drive, Ste. U-w, Glen Burnie, MD 21061 | 2018-06-27 |
| 1205351905 | Digna Emerita Sanchez De Vasquez | Specialist/Technologist, Other | 201 Fernglen Ave, Glen Burnie, MD 21061 | 2017-08-03 |
| 1255780300 | Rachel Cutts | Physical Therapist | 7711 Quarterfield Rd Ste C2, Glen Burnie, MD 21061 | 2016-06-09 |
| 1295181170 | Gaudenzia, Inc. | Counselor | 5 Crain Highway North - Rear Suite Entrance, Glen Burnie, MD 21061 | 2016-05-10 |
| 1023499548 | Mary Bourbon | Nurse Practitioner | 1600 S. Cain Highway, Suite 401, Glen Burnie, MD 21061 | 2015-06-10 |
| 1972997724 | Robert Oladeinde | Physician Assistant | 6934 Aviation Blvd Suite B, Glen Burnie, MD 21061 | 2015-03-18 |
| 1205248069 | Cathy Qing He | Anesthesiology | 1600 Crain Hwy S Ste 301, Glen Burnie, MD 21061 | 2014-05-28 |
| 1477974764 | Shannon Holder | Nurse Practitioner | 1916 Crain Hwy S Ste 2, Glen Burnie, MD 21061 | 2014-01-03 |
| 1629404207 | Marla Ann Muha | Physician Assistant | 301 Hospital Dr # 803, Glen Burnie, MD 21061 | 2013-09-16 |
| Find all providers in zip 21061 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477151066 | Evolve Residential, LLC | Substance Abuse Rehabilitation Facility | 486 Lincoln Dr, Glen Burnie, MD 21060-8706 | 2020-10-15 |
| 1841898434 | Evolve Residential, LLC | Substance Abuse Rehabilitation Facility | 394 Washington Ave, Glen Burnie, MD 21060-8712 | 2020-10-15 |
| 1124626296 | Evolve Residential, LLC | Substance Abuse Rehabilitation Facility | 390 Washington Ave, Glen Burnie, MD 21060-8712 | 2020-10-12 |
| 1245568757 | Alcohol and Drug Intervention, Inc | Substance Abuse Rehabilitation Facility | 7458 Baltimore Annapolis Blvd, 2nd Floor, Glen Burnie, MD 21061-3541 | 2009-11-20 |
| 1790277085 | Health & Wellness Outpatient Treatment Services, LLC | Substance Abuse Rehabilitation Facility | 408 Crain Hwy S Ste 6, Glen Burnie, MD 21061 | 2018-06-01 |
| 1346747029 | Second Chance Recovery House LLC | Substance Abuse Rehabilitation Facility | 1410 Crain Hwy N Ste 5b, Glen Burnie, MD 21061-9304 | 2018-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942808050 | Powell Recovery Center, Inc. | Substance Abuse Rehabilitation Facility | 10 S Broadway, Baltimore, MD 21231-1775 | 2020-10-12 |
| 1396343414 | Powell Recovery Center, Inc. | Substance Abuse Rehabilitation Facility | 15 S Broadway, Baltimore, MD 21231-1714 | 2020-10-12 |
| 1801494984 | Evolve Residential, LLC | Substance Abuse Rehabilitation Facility | 8315 Veterans Hwy, Millersville, MD 21108-1421 | 2020-10-12 |
| 1457968984 | Powell Recovery Center | Substance Abuse Rehabilitation Facility | 22 S Broadway, Baltimore, MD 21231-1711 | 2020-09-29 |
| 1356956676 | The Elysian Fields Optimum Wellness and Mental Health Group, LLC | Substance Abuse Rehabilitation Facility | 2901 Erdman Ave, Baltimore, MD 21213-1139 | 2020-09-14 |
| 1134731284 | Serenity Keepers of Maryland LLC | Substance Abuse Rehabilitation Facility | 3645 Cottage Ave, Baltimore, MD 21215-7725 | 2020-08-20 |
| 1255949392 | Champ House Recovery Inc. | Substance Abuse Rehabilitation Facility | 8655 Normal School Rd, Bowie, MD 20715-3326 | 2020-07-15 |
| 1447875216 | Unlimited Bounds Human Services LLC | Substance Abuse Rehabilitation Facility | 504 Beaumont Ave, Baltimore, MD 21212-4310 | 2020-06-08 |
| 1417577966 | Royal Minds Inc | Substance Abuse Rehabilitation Facility | 928 W Franklin St, Baltimore, MD 21223-1337 | 2020-04-24 |
| 1912527722 | Royal Minds Inc | Substance Abuse Rehabilitation Facility | 533 Chateau Ave, Baltimore, MD 21212-4306 | 2020-04-22 |
| Find all providers with the same taxonomy | ||||
| City | GLEN BURNIE |
| Zip Code | 21061 |
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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.