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General NPI Number Information
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NPI Number | 1477570059
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Entity Type | Organization
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Legal Business Name | ARCHWAY STATION INC
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 45 QUEEN ST.
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City | CUMBERLAND
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State | MD
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Zip | 21502
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Country | US
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Telephone | 301-777-1700
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Fax | 301-724-1209
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Provider Business Mailing Address
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Address Line | 45 QUEEN ST
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City | CUMBERLAND
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State | MD
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Zip | 21502
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Country | US
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Telephone | 301-777-1700
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Fax | 301-724-1209
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Authorized Official
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Title or Position | BEHAVIORAL HEALTH PROGRAM DIRECTOR
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Name | STEPHANIE MOORE
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Credential |
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Telephone | 301-777-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number |
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License Number State |
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