| Upper Bay Counseling & Support Services, Inc | |
|
1275b W Pulaski Hwy Elkton MD 21921-4719 | |
| (410) 620-7161 | |
| (410) 398-3416 |
| Full Name | Upper Bay Counseling & Support Services, Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1275b W Pulaski Hwy, Elkton, Maryland |
| Authorized Official Name and Position | Robert Shank (IT MANAGER) |
| Authorized Official Contact | 4109963400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Upper Bay Counseling & Support Services, Inc 200 Booth St Elkton MD 21921-5657 Ph: (410) 996-3400 | Upper Bay Counseling & Support Services, Inc 1275b W Pulaski Hwy Elkton MD 21921-4719 Ph: (410) 620-7161 |
| NPI Number | 1255861225 |
|---|---|
| Provider Enumeration Date | 06/13/2017 |
| Last Update Date | 06/13/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255861225 | NPI | - | NPPES |
| 922801201 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1989 (Maryland) | Primary |
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