Provider Demographics
NPI:1104505809
Name:RECLAIM INTEGRATED CARE, LLC
Entity type:Organization
Organization Name:RECLAIM INTEGRATED CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON BEY
Authorized Official - Suffix:
Authorized Official - Credentials:CSC-AD
Authorized Official - Phone:443-472-1202
Mailing Address - Street 1:8241 PHILADELPHIA RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-2842
Mailing Address - Country:US
Mailing Address - Phone:443-472-1202
Mailing Address - Fax:
Practice Address - Street 1:8241 PHILA RD UNIT B
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-2842
Practice Address - Country:US
Practice Address - Phone:443-472-1202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty