Provider Demographics
NPI:1720438591
Name:ANNE ARUNDEL COUNTY DEPARTMENT OF HEALTH
Entity Type:Organization
Organization Name:ANNE ARUNDEL COUNTY DEPARTMENT OF HEALTH
Other - Org Name:ROAD TO RECOVERY SOUTH
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR, BEHAVIORAL HEALTH
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:O'NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-222-7164
Mailing Address - Street 1:3 HARRY S TRUMAN PKWY
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7031
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:711 BESTGATE RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-2453
Practice Address - Country:US
Practice Address - Phone:410-222-6001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANNE ARUNDEL CO DEPT OF HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-13
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QM2800X
261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone