Healthcare Provider Details
I. General information
NPI: 1255808457
Provider Name (Legal Business Name): SAMARITAN HOUSE INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/26/2018
Last Update Date: 03/04/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2610 GREENBRIAR LN BLDG 1
ANNAPOLIS MD
21401-4424
US
IV. Provider business mailing address
2610 GREENBRIAR LN BLDG 1
ANNAPOLIS MD
21401-4424
US
V. Phone/Fax
- Phone: 410-269-5605
- Fax:
- Phone: 410-269-5605
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CYNTHIA
BETH
HURD
Title or Position: OFFICE MANAGER
Credential:
Phone: 410-269-5605