Provider Demographics
NPI:1104373562
Name:ASHLEY, INC.
Entity Type:Organization
Organization Name:ASHLEY, INC.
Other - Org Name:ASHLEY ADDICTION TREATMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:410-273-2207
Mailing Address - Street 1:800 TYDINGS LN
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-2102
Mailing Address - Country:US
Mailing Address - Phone:800-799-4673
Mailing Address - Fax:410-273-2290
Practice Address - Street 1:111 W HIGH ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5529
Practice Address - Country:US
Practice Address - Phone:443-760-3620
Practice Address - Fax:443-371-2638
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASHLEY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD100634103TA0400X, 207QA0401X, 2084A0401X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty