MARYLAND TREATMENT CENTERS INC. NPI 1245534676

NPI Information

NPI: 1245534676
Provider Name: MARYLAND TREATMENT CENTERS, INC.

Doing Business As: MOUNTAIN MANOR ADULT OUTPATIENT

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
3243 EASTERN AVE
BALTIMORE, MD
ZIP 21224
Phone: (410) 276-0153
Get Directions

MARYLAND TREATMENT CENTERS, INC. is a rehabilitation and substance use disorder clinic center in Baltimore, MD. MARYLAND TREATMENT CENTERS, INC. NPI is 1245534676. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mountain Manor Adult Outpatient.

The provider's business location address is:

3243 EASTERN AVE
BALTIMORE, MD
ZIP 21224-013
Phone: (410) 276-0153
Fax: (410) 732-0362

The provider's authorized official is William J Roby .
The authorized official title is Executive Vice President and has the following contact phone number (301) 447-2361.

The enumeration date for this NPI number is 12/28/2010 and was last updated on 12/28/2010.

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
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)			No
2	101YP2500X	Counselor	Professional			No
3	1041C0700X	Social Worker	Clinical			No
4	2084A0401X	Psychiatry & Neurology	Addiction Medicine			No
5	2084P0800X	Psychiatry & Neurology	Psychiatry			No
6	2084P0802X	Psychiatry & Neurology	Addiction Psychiatry			No
7	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	903870	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	PENDING	MEDICAID	MARYLAND

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: 4/28/2024

NPI Synchronization or Removal

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