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General NPI Number Information
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NPI Number | 1013864750
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Entity Type | Organization
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Legal Business Name | HAGERSTOWN RECOVERY LLC
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Dates
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Enumeration Date | 03/12/2026
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 9055 SHADY GROVE CT
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City | GAITHERSBURG
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State | MD
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Zip | 20877-1301
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Country | US
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Telephone | 301-355-7455
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Fax | 240-489-6777
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Provider Business Mailing Address
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Address Line | 19120 MUNCASTER RD
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City | DERWOOD
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State | MD
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Zip | 20855-2406
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Country | US
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Telephone | 301-665-7940
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Fax | 240-489-6777
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BRETT GOLDENBERG
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Credential |
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Telephone | 301-665-7940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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