Green Ridge Youth Center | |
10700 15 Mile Crk Road Flintstone MD 21530-3038 | |
(301) 478-3069 | |
(301) 478-3009 |
Full Name | Green Ridge Youth Center |
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Speciality | Community/behavioral Health |
Location | 10700 15 Mile Crk Road, Flintstone, Maryland |
Authorized Official Name and Position | Tammy Lynn Fisher (ADMINISTRATOR-CLINICAL SUPERVISOR) |
Authorized Official Contact | 3014783069 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Green Ridge Youth Center 10700 15 Mile Crk Road Flintstone MD 21530-3038 Ph: (301) 478-3069 | Green Ridge Youth Center 10700 15 Mile Crk Road Flintstone MD 21530-3038 Ph: (301) 478-3069 |
NPI Number | 1750502829 |
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Provider Enumeration Date | 05/02/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1750502829 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |