21D2173270 CLIA NUMBER - MONTE NIDO MARYLAND LLC

Laboratory Demographics

CLIA Number: 21D2173270

Facility Name: MONTE NIDO MARYLAND LLC

Facility Address:
3100 ROXBURY MILLS ROAD
GLENWOOD, MD
ZIP 21738
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Facility Phone Number: 410 849-6116

Facility Type: Other - LIMITED PRIVATE INPATIENT

Certificate Type: Waiver

NPI Number: 1649744327

Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

CLIA Record

Field Name	Field Value
CLIA Number	21D2173270
LAB Type	Other - LIMITED PRIVATE INPATIENT
Facility Name	MONTE NIDO MARYLAND LLC
Street	3100 ROXBURY MILLS ROAD
City	GLENWOOD
State	MD
ZIP	21738
Phone	410 849-6116
CertificateType	4
CertificateEffectiveDate	10/9/2023
CertificateExpirationDate	10/8/2025
FacilityType	Waiver

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