Provider Demographics
NPI:1295841781
Name:ROCK CREEK FOUNDATION FOR MENTAL HEALTH INC
Entity Type:Organization
Organization Name:ROCK CREEK FOUNDATION FOR MENTAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERIC
Authorized Official - Middle Name:B
Authorized Official - Last Name:CHANTEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-572-6585
Mailing Address - Street 1:12120 PLUM ORCHARD DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7820
Mailing Address - Country:US
Mailing Address - Phone:301-572-6585
Mailing Address - Fax:301-572-5046
Practice Address - Street 1:12120 PLUM ORCHARD DR
Practice Address - Street 2:SUITE B
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7820
Practice Address - Country:US
Practice Address - Phone:301-572-6585
Practice Address - Fax:301-572-5046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities