Provider Demographics
NPI:1740969989
Name:GRASONVILLE HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:GRASONVILLE HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPONSOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C, LCADC
Authorized Official - Phone:443-904-3424
Mailing Address - Street 1:125 SLADE AVE
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4907
Mailing Address - Country:US
Mailing Address - Phone:443-904-3424
Mailing Address - Fax:410-413-0257
Practice Address - Street 1:101 DRUMMER DR
Practice Address - Street 2:
Practice Address - City:GRASONVILLE
Practice Address - State:MD
Practice Address - Zip Code:21638-1202
Practice Address - Country:US
Practice Address - Phone:443-904-3424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone