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General NPI Number Information
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NPI Number | 1366585739
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Entity Type | Organization
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Legal Business Name | COLUMBIA ADDICTIONS CENTER
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5570 STERRETT PL SUITE 205
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City | COLUMBIA
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State | MD
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Zip | 21044-2641
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Country | US
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Telephone | 410-730-1333
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Fax | 410-730-1559
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Provider Business Mailing Address
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Address Line | 5570 STERRETT PL SUITE 205
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City | COLUMBIA
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State | MD
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Zip | 21044-2641
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Country | US
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Telephone | 410-730-1333
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Fax | 410-730-1559
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. EILEEN DEWEY
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Credential | L.C.S.W.-C
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Telephone | 410-730-1333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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