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2903 Pulaski Hwy Edgewood MD 21040-1311 | |
| (443) 402-0185 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 2903 Pulaski Hwy, Edgewood, Maryland |
| Authorized Official Name and Position | Alicia Danelle Myers-pope (CEO/OWNER) |
| Authorized Official Contact | 4434020185 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3709 Pulaski Hwy Ste 8 Abingdon MD 21009-1302 Ph: (443) 402-0185 | 2903 Pulaski Hwy Edgewood MD 21040-1311 Ph: (443) 402-0185 |
| NPI Number | 1467285510 |
|---|---|
| Provider Enumeration Date | 08/23/2024 |
| Last Update Date | 02/04/2025 |
| Certification Date | 02/04/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467285510 | NPI | - | NPPES |
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