| Mountain Md Prp | |
|
308 Virginia Ave Cumberland MD 21502-4559 | |
| (667) 600-2110 | |
| Not Available |
| Full Name | Mountain Md Prp |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 308 Virginia Ave, Cumberland, Maryland |
| Authorized Official Name and Position | Gloris Reeves (A/R AND BILLING MANAGER) |
| Authorized Official Contact | 6676002249 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Md Prp 2300 Dulaney Valley Rd Timonium MD 21093-2739 Ph: (667) 600-2249 | Mountain Md Prp 308 Virginia Ave Cumberland MD 21502-4559 Ph: (667) 600-2110 |
| NPI Number | 1447554662 |
|---|---|
| Provider Enumeration Date | 01/03/2011 |
| Last Update Date | 01/03/2020 |
| Certification Date | 01/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447554662 | NPI | - | NPPES |
| 419835207 | Medicaid | MD | |
| 419835200 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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