Ryan Rehabilitation | |
19586 Club House Rd Montgomery Village MD 20886-3002 | |
(301) 258-7771 | |
(301) 258-9078 |
Full Name | Ryan Rehabilitation |
---|---|
Speciality | Counselor - Mental Health |
Location | 19586 Club House Rd, Montgomery Village, Maryland |
Authorized Official Name and Position | Tracy Asbury (BILLING MANAGER) |
Authorized Official Contact | 3019429773 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Ryan Rehabilitation 19586 Club House Rd Montgomery Village MD 20886-3002 Ph: (301) 258-7771 | Ryan Rehabilitation 19586 Club House Rd Montgomery Village MD 20886-3002 Ph: (301) 258-7771 |
NPI Number | 1790102531 |
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Provider Enumeration Date | 03/18/2014 |
Last Update Date | 03/18/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790102531 | NPI | - | NPPES |
415645500 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | LCA372 (Maryland) | Secondary |
101YM0800X | Counselor - Mental Health | LC1361 (Maryland) | Primary |
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