# ALCOHOL AND DRUG INTERVENTION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427449172
- **Authorized official:** MRS. MINDY FLEETWOOD (PRESIDENT)
- **Authorized official phone:** (410) 787-2288

## Contact information

- **Practice address:** 7458 BALTIMORE ANNAPOLIS BLVD, 2ND FLOOR, GLEN BURNIE, MD 21061-3541
- **Practice address phone:** (410) 787-2288
- **Practice address fax:** (410) 787-9479
- **Mailing address:** 7458 BALTIMORE ANNAPOLIS BLVD, GLEN BURNIE, MD 21061-3541
- **Mailing address phone:** (410) 787-2288
- **Mailing address fax:** (410) 787-9479

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/16/2015
- **Last updated:** 12/08/2020