Provider Demographics
NPI:1093175408
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:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-447-2361
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:301-447-3715
Practice Address - Street 1:2801 CHEVERLY AVE
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-3125
Practice Address - Country:US
Practice Address - Phone:301-772-5174
Practice Address - Fax:301-772-5647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD905876261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder