Provider Demographics
NPI:1477005387
Name:ROCK CREEK FOUNDATION
Entity Type:Organization
Organization Name:ROCK CREEK FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-572-6585
Mailing Address - Street 1:12200 TECH RD
Mailing Address - Street 2:STE 330
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1983
Mailing Address - Country:US
Mailing Address - Phone:301-572-6585
Mailing Address - Fax:
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:301-586-0900
Practice Address - Fax:301-586-0908
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AFFILIATED SANTE GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD5559251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health