Provider Demographics
NPI:1629024039
Name:ADVANCED BEHAVIORAL CARE, INC.
Entity Type:Organization
Organization Name:ADVANCED BEHAVIORAL CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:STIELPER
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:410-599-7400
Mailing Address - Street 1:23562 CANOE CT
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-5443
Mailing Address - Country:US
Mailing Address - Phone:410-599-7400
Mailing Address - Fax:
Practice Address - Street 1:1432 VALLEY FORGE WAY
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-2706
Practice Address - Country:US
Practice Address - Phone:410-599-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD124942800Medicaid
MD544LMedicare ID - Type Unspecified