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General NPI Number Information
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NPI Number | 1760439830
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Entity Type | Organization
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Legal Business Name | PINNACLE CENTER FOR MENTAL HEALTH & HUMAN RELATIONS LLC
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 03/09/2011
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Provider Practice Location Address
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Address Line | 603 POST OFFICE RD SUITE 210
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City | WALDORF
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State | MD
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Zip | 20602-1914
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Country | US
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Telephone | 301-705-7593
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Fax |
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Provider Business Mailing Address
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Address Line | 603 POST OFFICE RD SUITE 210
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City | WALDORF
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State | MD
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Zip | 20602-1914
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | DR. CHARLES L RUBY
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Credential | PH.D.
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Telephone | 301-705-7593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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