Healthcare Provider Details
I. General information
NPI: 1154626752
Provider Name (Legal Business Name): MARYLAND TREATMENT CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/13/2011
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1107 NORTH POINT BLVD STE 205
BALTIMORE MD
21224-3401
US
IV. Provider business mailing address
9701 KEYSVILLE RD
EMMITSBURG MD
21727-8619
US
V. Phone/Fax
- Phone: 410-276-0153
- Fax: 410-732-0362
- Phone: 301-447-2361
- Fax: 301-447-3673
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | 903870 |
| License Number State | MD |
VIII. Authorized Official
Name: MS.
SARAH
D
BOLEK
Title or Position: ASSOC DIR CONTRACTS
Credential:
Phone: 240-401-3062