| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 251 N 4th St, Oakland, Maryland |
| Authorized Official Name and Position | Tracy Lipscomb (SVP OF FINANCE & CFO) |
| Authorized Official Contact | 3015334000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 594 Oakland MD 21550-4594 Ph: () - | 251 N 4th St Oakland MD 21550-1375 Ph: (301) 533-4000 |
| NPI Number | 1225707532 |
|---|---|
| Provider Enumeration Date | 09/09/2021 |
| Last Update Date | 05/31/2022 |
| Certification Date | 05/31/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225707532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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