Provider Demographics
NPI:1972644722
Name:WASHINGTON COUNTY HUMAN DEVELOPMENT COUNCIL, INC.
Entity type:Organization
Organization Name:WASHINGTON COUNTY HUMAN DEVELOPMENT COUNCIL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DAY PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-791-5421
Mailing Address - Street 1:433 BREWER AVE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5364
Mailing Address - Country:US
Mailing Address - Phone:301-791-5421
Mailing Address - Fax:301-791-0355
Practice Address - Street 1:433 BREWER AVE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5364
Practice Address - Country:US
Practice Address - Phone:301-791-5421
Practice Address - Fax:301-791-0355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13285261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care