| Avery Road Treatment Center | |
|
14703 Avery Rd Rockville MD 20853-3605 | |
| (301) 762-5613 | |
| (301) 762-3451 |
| Full Name | Avery Road Treatment Center |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 14703 Avery Rd, Rockville, Maryland |
| Authorized Official Name and Position | William J. Roby (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Contact | 3014472361 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avery Road Treatment Center 14703 Avery Rd Rockville MD 20853-3605 Ph: (301) 762-5613 | Avery Road Treatment Center 14703 Avery Rd Rockville MD 20853-3605 Ph: (301) 762-5613 |
| NPI Number | 1437317559 |
|---|---|
| Provider Enumeration Date | 05/27/2008 |
| Last Update Date | 05/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437317559 | NPI | - | NPPES |
| 090501103 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Maryland) | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | (Maryland) | Primary |
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