OrganizationActive
Outreach Recovery II
NPI 1114614526 · Addiction Medicine (Internal Medicine) Physician · Lexington Park, MD
Provider details
- NPI number
- 1114614526
- Entity type
- Organization
- Primary specialty
- Addiction Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Outreach Recovery II
- Organization subpart
- Yes
- Authorized official
- Isiah Coles, Coo(561) 502-3978
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
21552 Thames Ave Ste 201202
Lexington Park, MD 20653-4009
Phone: (410) 800-4466
Approximate (ZIP-level) locationGet directions
Mailing address
14205 Park Center Dr # 201202
Laurel, MD 20707-5246
Registry dates
- Enumerated
- 2023-04-18
- Last updated
- 2024-07-31
- Certified
- 2024-07-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.