IDAS PLACE LLC NPI 1194583146

NPI Information

  • NPI: 1194583146
  • Provider Name: IDAS PLACE LLC
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • Address: 583 FREDERICK RD STE 3A
    CATONSVILLE, MD
    ZIP 21228
  • Phone: (443) 710-3061

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NPI Details

IDAS PLACE LLC is a rehabilitation and substance use disorder clinic center in Catonsville, MD. IDAS PLACE LLC NPI is 1194583146. The provider is registered as an organization entity type.

The provider's business location address is:

583 FREDERICK RD STE 3A
CATONSVILLE, MD
ZIP 21228-697
Phone: (443) 710-3061
Fax: (410) 747-5001

The provider's authorized official is Dominique E Liverpool .
The authorized official title is President and has the following contact phone number (443) 710-3061.

The enumeration date for this NPI number is 3/13/2024 and was last updated on 4/17/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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