Organization · NPI-2

City Wide Treatment Center

Clinic/Center, Methadone Clinic · Bowie, MD

NPI number1063766558
StatusActive
Last updated in NPPESNov 5, 2012

Details

NPI
1063766558
Entity type
Organization (NPI-2)
Legal business name
City Wide Treatment Center
Organization subpart
No
Enumeration date
Nov 5, 2012
Last updated
Nov 5, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM2800X Clinic/Center, Methadone Clinic––Yes
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––
261QM0855X Clinic/Center, Adolescent and Children Mental Health––
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder––

Practice location

9104 Wipkey Ct
Bowie, MD 20720-3233

Phone 301-464-9617

Mailing address

9104 Wipkey Ct
Bowie, MD 20720-3233

Phone 301-464-9617

Authorized official

Damon Eugene Hall
Ceo
2024097467

Is something wrong?

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