Provider Demographics
NPI:1649593815
Name:AFFILIATED ADDICTIONS SERVICES LLC
Entity Type:Organization
Organization Name:AFFILIATED ADDICTIONS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C, BCD, MAC
Authorized Official - Phone:443-523-2594
Mailing Address - Street 1:323 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-4949
Mailing Address - Country:US
Mailing Address - Phone:443-523-2594
Mailing Address - Fax:410-548-3341
Practice Address - Street 1:323 BROAD ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-4949
Practice Address - Country:US
Practice Address - Phone:443-523-2594
Practice Address - Fax:410-548-3341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder