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Organization

POTOMAC RIDGE BEHAVORIAL HEALTH EASTERN SHORE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS CAROLYN F WITT LCSW-C (SCHOOL SOCIAL WORKER)
(410) 221-0288
Entity
Organization

Contact information

Practice address
821 FIELDCREST RD, CAMBRIDGE, MD 21613-9423
(410) 221-0288
(410) 228-9588
Mailing address
821 FIELDCREST RD, CAMBRIDGE, MD 21613-9423
(410) 221-0288
(410) 228-9588

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
10966
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
410520600
MD
05
410978300
MD
Enumeration date
02/26/2007
Last updated
06/23/2008
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