Organization
SOUTHERN MARYLAND COMMUNITY NETWORK INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN E CARLONI (EXECUTIVE DIRECTOR)
(410) 535-4787
Entity
Organization
Contact information
Practice address
2670 CRAIN HWY, SUITE #505, WALDORF, MD 20601-2806
(301) 932-9146
(301) 932-9361
Mailing address
PO BOX 998, PRINCE FREDERICK, MD 20678-0998
(410) 535-4787
(410) 535-4965
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2578417 03
—
MD
Enumeration date
06/30/2011
Last updated
04/05/2017
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