Provider Demographics
NPI:1922698232
Name:SANDSTONE CARE MARYLAND, LLC
Entity Type:Organization
Organization Name:SANDSTONE CARE MARYLAND, LLC
Other - Org Name:SANDSTONE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:MARCELLO
Authorized Official - Middle Name:
Authorized Official - Last Name:LA ROCCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-228-2384
Mailing Address - Street 1:7555 E HAMPDEN AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4832
Mailing Address - Country:US
Mailing Address - Phone:888-228-2384
Mailing Address - Fax:888-850-1860
Practice Address - Street 1:2017 MARTINS GRANT CT
Practice Address - Street 2:
Practice Address - City:CROWNSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21032-1932
Practice Address - Country:US
Practice Address - Phone:888-850-1890
Practice Address - Fax:888-850-1860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-20
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No291U00000XLaboratoriesClinical Medical Laboratory