| Way Station, Inc. | |
|
9568 Joey Dr Ellicott City MD 21042-2456 | |
| (301) 662-0099 | |
| (301) 662-1071 |
| Full Name | Way Station, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9568 Joey Dr, Ellicott City, Maryland |
| Authorized Official Name and Position | Robin Guy Elchin (BILLING DIRECTOR) |
| Authorized Official Contact | 3016620099 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Way Station, Inc. Po Box 3826 Frederick MD 21705-3826 Ph: (301) 662-0099 | Way Station, Inc. 9568 Joey Dr Ellicott City MD 21042-2456 Ph: (301) 662-0099 |
| NPI Number | 1972106110 |
|---|---|
| Provider Enumeration Date | 11/19/2020 |
| Last Update Date | 11/19/2020 |
| Certification Date | 11/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972106110 | NPI | - | NPPES |
| 588931600 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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