Provider Demographics
NPI:1831626936
Name:MARYLAND TREATMENT CENTERS INC
Entity type:Organization
Organization Name:MARYLAND TREATMENT CENTERS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTRACTS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-401-3062
Mailing Address - Street 1:9701 KEYSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:EMMITSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21727-8619
Mailing Address - Country:US
Mailing Address - Phone:301-447-2361
Mailing Address - Fax:
Practice Address - Street 1:3800 FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-3618
Practice Address - Country:US
Practice Address - Phone:410-233-1400
Practice Address - Fax:410-233-1666
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARYLAND TREATMENT CENTERS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-19
Last Update Date:2017-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility