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General NPI Number Information
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NPI Number | 1265676571
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Entity Type | Organization
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Legal Business Name | THE JUDE HOUSE, INC.
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Dates
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Enumeration Date | 04/30/2009
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 8806 DOVE DR
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City | BEL ALTON
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State | MD
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Zip | 20611-3003
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Country | US
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Telephone | 301-932-0700
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Fax |
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Provider Business Mailing Address
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Address Line | 9400 IRVING RD
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City | BEL ALTON
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State | MD
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Zip | 20611-3148
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Country | US
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Telephone | 301-932-0700
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Fax | 301-609-9236
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. SUSIE EILEEN THOMPSON
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Credential | LMSW
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Telephone | 301-932-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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