Organization · NPI-2

Adolescent And Family Services/Addictions

Clinic/Center · Annapolis, MD

NPI number1902175128
StatusActive
Last updated in NPPESDec 11, 2014

Details

NPI
1902175128
Entity type
Organization (NPI-2)
Legal business name
Adolescent And Family Services/Addictions
Organization subpart
Yes
Enumeration date
Dec 16, 2011
Last updated
Dec 11, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center904875MDYes

Practice location

3 Harry S Truman Pkwy
Hd#19
Annapolis, MD 21401-7031

Phone 410-222-7135 · Fax 410-222-4173

Mailing address

122 Langley Rd N
Ste A
Glen Burnie, MD 21060-6531

Phone 410-222-6725 · Fax 410-222-6888

Authorized official

Timothy Laureska
Deputy Health Officer/Operations
4102227377

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