Healthcare Provider Details

I. General information

NPI: 1073802138
Provider Name (Legal Business Name): WORCESTER COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2011
Last Update Date: 07/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

926 SNOW HILL ROAD COTTAGE 200, HOLLY CENTER, CENTER 4 CLEAN START
SALISBURY MD
21804
US

IV. Provider business mailing address

6040 PUBLIC LANDING RD
SNOW HILL MD
21863-2453
US

V. Phone/Fax

Practice location:
  • Phone: 410-742-3460
  • Fax: 410-742-5810
Mailing address:
  • Phone: 410-632-1100
  • Fax: 410-632-2476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number905074
License Number StateMD

VIII. Authorized Official

Name: HEATHER BARTON
Title or Position: DIRECTOR, ADMINISTRATIVE SERVICES
Credential:
Phone: 410-632-1100