| Carroll County Youth Service Bureau, Inc. | |
|
59 Kate Wagner Rd. Westminster MD 21157 | |
| (410) 848-2500 | |
| (410) 876-3016 |
| Full Name | Carroll County Youth Service Bureau, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 59 Kate Wagner Rd., Westminster, Maryland |
| Authorized Official Name and Position | Lynn D Davis (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4108482500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carroll County Youth Service Bureau, Inc. 59 Kate Wagner Rd Westminster MD 21157-6957 Ph: (410) 848-2500 | Carroll County Youth Service Bureau, Inc. 59 Kate Wagner Rd. Westminster MD 21157 Ph: (410) 848-2500 |
| NPI Number | 1871669721 |
|---|---|
| Provider Enumeration Date | 11/24/2006 |
| Last Update Date | 02/15/2023 |
| Certification Date | 02/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871669721 | NPI | - | NPPES |
| 532201400 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 6884 (Maryland) | Primary |
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