Organization
QUEEN ANNE'S COUNTY HEALTH DEPARTMENT
Active
Parent organization
QUEEN ANNE'S COUNTY HEALTH DEPARTMENT
Other names
Queen Anne's County Alcohol and Drug Abuse Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
QUEEN ANNE'S COUNTY HEALTH DEPARTMENT
Authorized official
MR. GARY B FRY LCADC (PROGRAM DIRECTOR)
(410) 758-1306
Entity
Organization
Contact information
Practice address
205 N LIBERTY ST, CENTREVILLE, MD 21617-1022
(410) 758-1306
(410) 758-2133
Mailing address
206 N COMMERCE ST, CENTREVILLE, MD 21617-1049
(410) 758-1306
(410) 758-2133
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
750325
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01372281
AMERIGROUP MA MCO
MD
01
—
019364
RIVERSIDE MA MCO
MD
01
—
056064
PRIORITY PARTNERS PAC MCO
MD
01
—
420917600
JAI MEDICAL MA MCO
MD
05
—
420917600
—
MD
01
—
H93
CAREFIRST BCBS OF MD
MD
Enumeration date
01/03/2012
Last updated
12/04/2014
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