| Ccs Columbia-facility (medicaid) | |
|
10630 Little Patuxent Pkwy Suite 209 Columbia MD 21044-6278 | |
| (410) 740-8066 | |
| (410) 740-8068 |
| Full Name | Ccs Columbia-facility (medicaid) |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 10630 Little Patuxent Pkwy, Columbia, Maryland |
| Authorized Official Name and Position | Amy Rottier (CFO) |
| Authorized Official Contact | 4107408066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ccs Columbia-facility (medicaid) 10630 Little Patuxent Pkwy Suite 209 Columbia MD 21044-6278 Ph: (410) 740-8066 | Ccs Columbia-facility (medicaid) 10630 Little Patuxent Pkwy Suite 209 Columbia MD 21044-6278 Ph: (410) 740-8066 |
| NPI Number | 1164820601 |
|---|---|
| Provider Enumeration Date | 12/16/2014 |
| Last Update Date | 10/28/2021 |
| Certification Date | 10/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164820601 | NPI | - | NPPES |
| 4231881 00 | Medicaid | MD |
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