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Organization
MONTGOMERY COUNTY MARYLAND GOVERNMENT
Active
Organization
MONTGOMERY COUNTY MARYLAND GOVERNMENT
Active
Other names
Seneca Valley School Based Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA AZUCENA CORTEZ (MANAGEMENT)
(240) 672-6758
Entity
Organization
Contact information
Practice address
19401 CRYSTAL ROCK DR, GERMANTOWN, MD 20874-1593
(240) 740-6402
Mailing address
19401 CRYSTAL ROCK DR, GERMANTOWN, MD 20874-1593
(240) 740-6402
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123456789
—
MD
Enumeration date
06/14/2021
Last updated
09/11/2025
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