Organization · NPI-2
11100 Billingsley Road Opco LLC
Substance Abuse Rehabilitation Facility · Waldorf, MD
NPI number1073021853
StatusActive
Last updated in NPPESOct 16, 2026
Details
- NPI
- 1073021853
- Entity type
- Organization (NPI-2)
- Legal business name
- 11100 Billingsley Road Opco LLC
- Organization subpart
- No
- Enumeration date
- Jan 16, 2018
- Certification date
- Oct 16, 2026
- Last updated
- Oct 16, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 324500000X | Substance Abuse Rehabilitation Facility | – | – | Yes |
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | – | – |
Other names
- The Maryland Center For Addiction Treatment (Other Name)
- Recovery Centers Of America At Waldorf (Other Name)
- Recovery Centers Of America At Capital Region (Doing Business As)
Practice location
11100 Billingsley RdWaldorf, MD 20602-3400
Phone 240-754-6100
Mailing address
7 N Waterloo RdPo Box 155
Devon, PA 19333-9998
Phone 610-994-2968
Authorized official
Serge Cruz
Corp Dir Patient Accounts
6104279434
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