Provider Demographics
NPI:1710149448
Name:ATS OF CECIL COUNTY,INC.
Entity Type:Organization
Organization Name:ATS OF CECIL COUNTY,INC.
Other - Org Name:WISE TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRATTON-PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW,CAC-AD,ADS
Authorized Official - Phone:410-477-3267
Mailing Address - Street 1:8801 WISE AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DUNDALK
Mailing Address - State:MD
Mailing Address - Zip Code:21222-5004
Mailing Address - Country:US
Mailing Address - Phone:410-477-3267
Mailing Address - Fax:410-477-3962
Practice Address - Street 1:8801 WISE AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-5004
Practice Address - Country:US
Practice Address - Phone:410-477-3267
Practice Address - Fax:410-477-3962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD903603251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health