CMS-1500 Box 24J / 33a • NPI
1831905348
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
324500000X
Licensed & Credentialed Substance Abuse Rehabilitation Facility
Box 32 Service Location & ZIP+4
3210 VICKERS RD, BALTIMORE, MD, 21216-1940
✓ 9-Digit EDI 837 ZIP+4 (21216-1940)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1831905348 (4 EVERGREEN RECOVERY HOMES AND SERVICES) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1831905348 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | 4 EVERGREEN RECOVERY HOMES AND SERVICES |
| Plain-English Specialty | Licensed & Credentialed Substance Abuse Rehabilitation Facility NUCC Code: 324500000X (Substance Abuse Rehabilitation Facility) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 3210 VICKERS RD, BALTIMORE, MD, 21216-1940 |
| Practice Telephone / Fax | Tel: (443) 924-3754 |
| Administrative Mailing Address | 3210 VICKERS RD, BALTIMORE, MD, 21216-1940 |
| Enumeration & Last Sync | Enumerated: 2024-12-09 | CMS Record Updated: 2024-12-09 |
| Authorized Official | COBLAH GREEN (OWNER) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (324500000X)
What Does Taxonomy Code 324500000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 324500000X translates to:
"Licensed & Credentialed Substance Abuse Rehabilitation Facility"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (4 EVERGREEN RECOVERY HOMES AND SERVICES)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
174200000X — MealsPlain English: Licensed & Credentialed Meals | State: N/A | License: Verified | Primary: Secondary |
177F00000X — LodgingPlain English: Licensed & Credentialed Lodging | State: N/A | License: Verified | Primary: Secondary |
251S00000X — Community/Behavioral HealthPlain English: Licensed & Credentialed Community/Behavioral Health | State: N/A | License: Verified | Primary: Secondary |
261QH0100X — Clinic/Center, Health ServicesPlain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: N/A | License: Verified | Primary: Secondary |
261QM0801X — Clinic/Center, Mental Health (Including Community Mental Health Center)Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: N/A | License: Verified | Primary: Secondary |
320800000X — Community Based Residential Treatment Facility, Mental IllnessPlain English: Licensed & Credentialed Community Based Residential Treatment Facility, Mental Illness | State: N/A | License: Verified | Primary: Secondary |
324500000X — Substance Abuse Rehabilitation FacilityPlain English: Licensed & Credentialed Substance Abuse Rehabilitation Facility | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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