21D2157061 CLIA NUMBER - HILDA'S PLACE BEHAVIORAL HEALTH ORG INC

Laboratory Demographics

CLIA Number: 21D2157061

Facility Name: HILDA'S PLACE BEHAVIORAL HEALTH ORG INC

Facility Address:
2480 ROXBURY MILLS ROAD
GLENWOOD, MD
ZIP 21738
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Facility Phone Number: 410 489-3737

Facility Type: Other - SUBSTANCE ABUSE

Certificate Type: Waiver

NPI Number: 1124609326

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	21D2157061
LAB Type	Other - SUBSTANCE ABUSE
Facility Name	HILDA'S PLACE BEHAVIORAL HEALTH ORG INC
Street	2480 ROXBURY MILLS ROAD
City	GLENWOOD
State	MD
ZIP	21738
Phone	410 489-3737
CertificateType	4
CertificateEffectiveDate	10/30/2022
CertificateExpirationDate	10/29/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024