Provider Demographics
NPI:1295850345
Name:ADDICTIONS COUNSELING SERVICE OF MARYLAND
Entity Type:Organization
Organization Name:ADDICTIONS COUNSELING SERVICE OF MARYLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:410-484-3333
Mailing Address - Street 1:17 WARREN RD
Mailing Address - Street 2:SUITE 26 B
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5334
Mailing Address - Country:US
Mailing Address - Phone:410-484-3333
Mailing Address - Fax:
Practice Address - Street 1:17 WARREN RD
Practice Address - Street 2:SUITE 26 B
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-5334
Practice Address - Country:US
Practice Address - Phone:410-484-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder