Provider Demographics
NPI:1821528332
Name:ALLEGANY COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:ALLEGANY COUNTY HEALTH DEPARTMENT
Other - Org Name:ALLEGANY COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ALLEGANY COUNTY HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JENELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:301-759-5000
Mailing Address - Street 1:P.O. BOX 1745
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21501-1745
Mailing Address - Country:US
Mailing Address - Phone:301-759-5000
Mailing Address - Fax:301-777-5674
Practice Address - Street 1:10102 COUNTRY CLUB RD SE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502
Practice Address - Country:US
Practice Address - Phone:301-777-2285
Practice Address - Fax:301-777-5832
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLEGANY COUNTY HEALTH DEPARTMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-16
Last Update Date:2017-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDBH000023324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility