| Mountain Manor Adult Outpatient | |
|
3243 Eastern Ave Baltimore MD 21224-4013 | |
| (410) 276-0153 | |
| (410) 732-0362 |
| Full Name | Mountain Manor Adult Outpatient |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 3243 Eastern Ave, Baltimore, 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 |
|---|---|
| Mountain Manor Adult Outpatient 3243 Eastern Ave Baltimore MD 21224-4013 Ph: (410) 276-0153 | Mountain Manor Adult Outpatient 3243 Eastern Ave Baltimore MD 21224-4013 Ph: (410) 276-0153 |
| NPI Number | 1144334178 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 01/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144334178 | NPI | - | NPPES |
| 510126300 | Medicaid | MD |
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