Provider Demographics
NPI:1598136459
Name:PROUD AND POSITIVE TREATMENT SERVICES INC.
Entity Type:Organization
Organization Name:PROUD AND POSITIVE TREATMENT SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:MED,CAC-AD,CCDC
Authorized Official - Phone:443-418-3386
Mailing Address - Street 1:100 WALTER WARD BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-1286
Mailing Address - Country:US
Mailing Address - Phone:410-707-9022
Mailing Address - Fax:
Practice Address - Street 1:602 REVOLUTION ST.
Practice Address - Street 2:SUITE 103
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078
Practice Address - Country:US
Practice Address - Phone:410-707-9022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-16
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center