Organization
DAY REPORTING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE BARLUP (FISCAL ACCOUNTS CLERK)
(240) 313-3492
Entity
Organization
Contact information
Practice address
1302 PENNSYLVANIA AVE, HAGERSTOWN, MD 21742-3108
(240) 313-3492
Mailing address
101 TANDY DR, HAGERSTOWN, MD 21740-5180
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
S285
—
MD
Enumeration date
10/06/2016
Last updated
10/06/2016
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