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General NPI Number Information
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NPI Number | 1750838777
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Entity Type | Organization
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Legal Business Name | PRINCE GEORGES COUNTY HEALTH DEPARTMENT
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Dates
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Enumeration Date | 09/07/2016
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Last Update Date | 09/07/2016
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Provider Practice Location Address
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Address Line | 925 BRIGHTSEAT RD
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City | LANDOVER
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State | MD
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Zip | 20785-4725
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Country | US
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Telephone | 301-909-2437
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Fax |
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Provider Business Mailing Address
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Address Line | 3316 BERO RD
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City | BALTIMORE
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State | MD
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Zip | 21227-4701
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Country | US
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Telephone | 410-660-7589
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Fax |
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Authorized Official
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Title or Position | ADDICTION COUNSELOR
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Name | MS. DANA MURPHY
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Credential | CSC-AD
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Telephone | 410-660-7589
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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 | SC1093
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License Number State | MD
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