Provider Demographics
NPI:1538598040
Name:MARYLAND RECOVERY ORGANIZATION CONNECTING COMMUNITIES (M-ROCC)
Entity type:Organization
Organization Name:MARYLAND RECOVERY ORGANIZATION CONNECTING COMMUNITIES (M-ROCC)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:MHS
Authorized Official - Phone:410-456-2228
Mailing Address - Street 1:5236 FREDCREST RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-3214
Mailing Address - Country:US
Mailing Address - Phone:410-456-2228
Mailing Address - Fax:
Practice Address - Street 1:3900 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-7602
Practice Address - Country:US
Practice Address - Phone:410-456-2228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty