Provider Demographics
NPI:1619403821
Name:DWI SERVICES INC
Entity Type:Organization
Organization Name:DWI SERVICES INC
Other - Org Name:AVENUES RECOVERY CENTER OF MARYLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HUDI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-967-2635
Mailing Address - Street 1:211 BOULEVARD OF THE AMERICAS
Mailing Address - Street 2:SUITE 503
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701
Mailing Address - Country:US
Mailing Address - Phone:732-967-2635
Mailing Address - Fax:
Practice Address - Street 1:125 FAIRGROUND RD
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4167
Practice Address - Country:US
Practice Address - Phone:410-535-8930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-08
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD905818324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility