Provider Demographics
NPI:1588857650
Name:A NEW WAY CLINIC INC
Entity Type:Organization
Organization Name:A NEW WAY CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PERRI
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:OKEEFE
Authorized Official - Suffix:
Authorized Official - Credentials:MA LCADC
Authorized Official - Phone:410-451-7323
Mailing Address - Street 1:2411 CROFTON LANE
Mailing Address - Street 2:SUITE 12
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-1349
Mailing Address - Country:US
Mailing Address - Phone:410-451-7323
Mailing Address - Fax:410-451-8205
Practice Address - Street 1:2411 CROFTON LANE
Practice Address - Street 2:SUITE 12
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-1349
Practice Address - Country:US
Practice Address - Phone:410-451-7323
Practice Address - Fax:410-451-8205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD105041101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty