Provider Demographics
NPI:1871982611
Name:ADDICTION RECOVERY INC
Entity type:Organization
Organization Name:ADDICTION RECOVERY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CP/IOP SUPERVISIOR
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BARTLINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C, LCADC
Authorized Official - Phone:410-923-6700
Mailing Address - Street 1:26 MARBURY DR
Mailing Address - Street 2:
Mailing Address - City:CROWNSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21062
Mailing Address - Country:US
Mailing Address - Phone:410-923-6700
Mailing Address - Fax:410-923-6213
Practice Address - Street 1:26 MARBURY DR
Practice Address - Street 2:
Practice Address - City:CROWNSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21032
Practice Address - Country:US
Practice Address - Phone:410-923-6700
Practice Address - Fax:410-923-6213
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EM BARTLINSKI AND ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-01-16
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA134101YA0400X
MDSC2109101YA0400X
MDLC1371101YA0400X, 101YP2500X
MDLC4453101YA0400X, 101YP2500X
MD11975101YA0400X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD133131100Medicaid
MDH285L955Medicare PIN
MD133131100Medicaid