Provider Demographics
NPI:1598734410
Name:DRUID HEIGHTS TREATMENT AND COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:DRUID HEIGHTS TREATMENT AND COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSTICK-HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-669-0475
Mailing Address - Street 1:2009 DRUID HILL AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-3519
Mailing Address - Country:US
Mailing Address - Phone:410-669-0475
Mailing Address - Fax:410-669-3681
Practice Address - Street 1:2009 DRUID HILL AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-3519
Practice Address - Country:US
Practice Address - Phone:410-669-0475
Practice Address - Fax:410-669-3681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD356110261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD659MMedicare ID - Type Unspecified