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General NPI Number Information
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NPI Number | 1730277435
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Entity Type | Organization
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Legal Business Name | MARYLAND TREATMENT CENTERS, INC.
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 174 THOMAS JOHNSON DR STE 101-102
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City | FREDERICK
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State | MD
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Zip | 21702-4423
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Country | US
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Telephone | 301-662-1407
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Fax | 301-662-6989
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Provider Business Mailing Address
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Address Line | 174 THOMAS JOHNSON DR STE 101-102
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City | FREDERICK
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State | MD
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Zip | 21702-4423
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Country | US
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Telephone | 301-662-1407
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Fax | 301-662-6989
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Authorized Official
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Title or Position | ASSOC DIR CONTRACTS
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Name | MS. SARAH D BOLEK
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Credential |
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Telephone | 240-401-3062
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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 | 903869
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License Number State | MD
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