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General NPI Number Information
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NPI Number | 1336363944
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Entity Type | Organization
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Legal Business Name | WASHINGTON COUNTY HUMAN DEVELOPMENT COUNCIL, INC.
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 916 N EAST ST
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City | FREDERICK
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State | MD
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Zip | 21701-4622
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Country | US
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Telephone | 301-293-6055
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Fax | 301-293-6089
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Provider Business Mailing Address
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Address Line | 916 N EAST ST
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City | FREDERICK
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State | MD
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Zip | 21701-4622
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Country | US
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Telephone | 301-293-6055
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Fax | 301-293-6089
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Authorized Official
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Title or Position | DIRECTOR OF DAY PROGRAM SERVICES
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Name | MR. DEREK DAVID SMITH
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Credential |
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Telephone | 301-791-5421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 13286
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License Number State | MD
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