Healthcare Provider Details

I. General information

NPI: 1801873989
Provider Name (Legal Business Name): ASHLEY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 TYDINGS LN
HAVRE DE GRACE MD
21078-2132
US

IV. Provider business mailing address

800 TYDINGS LN
HAVRE DE GRACE MD
21078-2102
US

V. Phone/Fax

Practice location:
  • Phone: 410-273-6600
  • Fax: 410-272-5617
Mailing address:
  • Phone: 410-273-2213
  • Fax: 410-344-2416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number13906
License Number StateMD

VIII. Authorized Official

Name: JENNIFER AGUGLIA
Title or Position: VICE PRESIDENT OF CLINICAL SERVICES
Credential:
Phone: 410-273-2462