Provider Demographics
NPI:1922244615
Name:MARYLAND TREATMENT CENTERS, INC.
Entity Type:Organization
Organization Name:MARYLAND TREATMENT CENTERS, INC.
Other - Org Name:SAFE PASSAGES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE DIRECTOR OF MENTAL HEALTH
Authorized Official - Prefix:MS
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-762-5613
Mailing Address - Street 1:2801 CHEVERLY AVE
Mailing Address - Street 2:3RD AND 4TH FLOOR
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-3125
Mailing Address - Country:US
Mailing Address - Phone:301-772-5174
Mailing Address - Fax:301-772-5647
Practice Address - Street 1:2801 CHEVERLY AVE
Practice Address - Street 2:3RD AND 4TH FLOOR
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-3125
Practice Address - Country:US
Practice Address - Phone:301-772-5174
Practice Address - Fax:301-772-5647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4091/22177261QM0801X, 261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD090501101Medicaid
MD4091/22177OtherSTATE CERTIFICATE AS OUTPATIENT MENTAL HEALTH CLINIC