Provider Demographics
NPI:1205590676
Name:HAGERSTOWN RECOVERY LLC
Entity type:Organization
Organization Name:HAGERSTOWN RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-538-4114
Mailing Address - Street 1:19120 MUNCASTER RD
Mailing Address - Street 2:
Mailing Address - City:DERWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20855-2406
Mailing Address - Country:US
Mailing Address - Phone:301-355-7455
Mailing Address - Fax:
Practice Address - Street 1:19120 MUNCASTER RD
Practice Address - Street 2:
Practice Address - City:DERWOOD
Practice Address - State:MD
Practice Address - Zip Code:20855-2406
Practice Address - Country:US
Practice Address - Phone:301-355-7455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility