Organization
SOUTHERN MARYLAND COMMUNITY NETWORK, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R. BENNETT (EXECUTIVE DIRECTOR)
(410) 535-4787
Entity
Organization
Contact information
Practice address
305 PRINCE FREDERICK BLVD, PRINCE FREDERICK,, MD 20678-3139
(410) 535-4787
(410) 535-4965
Mailing address
P.O. BOX 998, PRINCE FREDERICK,, MD 20678-3139
(410) 535-4787
(410) 535-4965
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
257841700
—
MD
05
—
268873500
—
MD
Enumeration date
03/13/2007
Last updated
04/01/2010
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