Provider Demographics
NPI:1952352957
Name:MID-ATLANTIC TREATMENT SERVICES, INC
Entity Type:Organization
Organization Name:MID-ATLANTIC TREATMENT SERVICES, INC
Other - Org Name:CROSSROADS CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUESTONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-752-6505
Mailing Address - Street 1:2100 N CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-5709
Mailing Address - Country:US
Mailing Address - Phone:410-752-6505
Mailing Address - Fax:410-385-1237
Practice Address - Street 1:2100 N CHARLES ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-5709
Practice Address - Country:US
Practice Address - Phone:410-752-6505
Practice Address - Fax:410-385-1237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12475261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center