| |
324 E Antietam St Ste 308 Hagerstown MD 21740-5768 | |
(301) 766-0065 | |
(301) 797-8610 |
Full Name | |
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Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 324 E Antietam St Ste 308, Hagerstown, Maryland |
Authorized Official Name and Position | Deanna K Bailey (OWNER/PROGRAM DIRECTOR) |
Authorized Official Contact | 3017660065 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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370 Virginia Avenue Hagerstown MD 21740 Ph: (301) 766-0065 | 324 E Antietam St Ste 308 Hagerstown MD 21740-5768 Ph: (301) 766-0065 |
NPI Number | 1285108001 |
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Provider Enumeration Date | 01/15/2019 |
Last Update Date | 08/09/2021 |
Certification Date | 07/27/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285108001 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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