| Ryan Rehabilitation Llc | |
|
19630 Club House Rd Ste 715 Montgomery Village MD 20886 | |
| (301) 258-7771 | |
| (301) 258-9078 |
| Full Name | Ryan Rehabilitation Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 19630 Club House Rd Ste 715, Montgomery Village, Maryland |
| Authorized Official Name and Position | Melanie Suthard (BILLING MANAGER) |
| Authorized Official Contact | 3019429773 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ryan Rehabilitation Llc 19630 Club House Rd Ste 715 Montgomery Village MD 20886-3040 Ph: (301) 258-7771 | Ryan Rehabilitation Llc 19630 Club House Rd Ste 715 Montgomery Village MD 20886 Ph: (301) 258-7771 |
| NPI Number | 1780164087 |
|---|---|
| Provider Enumeration Date | 08/16/2018 |
| Last Update Date | 09/25/2024 |
| Certification Date | 09/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780164087 | NPI | - | NPPES |
| 654084800 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
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