Organization Name: | MARYLAND TREATMENT CENTERS, INC |
NPI Number: | 1093175408 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM ROBY (CEO) |
Mailing Address: | 2801 Cheverly Ave Cheverly |
State: | MD US |
Postal Code: | 207853125 |
Phone Number: | 3017725174 |
Fax Number: | 3017725647 |
NPI Enumeration Date: | 02/26/2016 |
NPI Last Update Date: | 02/26/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0405X |
License Number: | 905876 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
Taxonomy Definition: |