MEDICARE: SAMARITAN HOUSES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1235940107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMARITAN HOUSES INC.

Provider Business Mailing Address
First Line	:	2610 GREENBRIAR LN BLDG 2
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-4424
Country	:	US
Telephone Number	:	410-991-3292
Fax Number	:

Provider Business Practice Location Address
First Line	:	2610 GREENBRIAR LN BLDG 2
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-4424
Country	:	US
Telephone Number	:	410-991-3292
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MICHAEL S GOLDFADEN
Credential	:	LMSW CAC-AD
Telephone Number	:	410-991-3292

Provider Enumeration Date	:	01/18/2025
Last Update Date	:	01/22/2025

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