Organization
MEDICATION ASSISTED TREATMENT TECHNOLOGIES, INC
Active
Other names
matt program
Organization subpart
No
Provider details
NPI number
Authorized official
MR. J. CHARLES SMITH JR. (C.E.O., SPONSOR)
(410) 322-6575
Entity
Organization
Contact information
Practice address
1361 BRASS MILL ROAD, BLDG. A, BELCAMP, MD 21017-1213
(410) 273-9700
(410) 273-9713
Mailing address
1361 BRASS MILL ROAD, BLDG. A, BELCAMP, MD 21017-1213
(410) 273-9700
(410) 273-9713
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
101202
MD
261QM2800X
Methadone Clinic
101202
MD
261QM2800X
Methadone Clinic
Primary
12234
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019661780001
—
PA
05
—
4034538-00
—
MD
05
—
403453800
—
MD
Enumeration date
10/18/2005
Last updated
12/01/2010
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