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Organization

FREDERICK INSTITUTE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. NEAL BERCH (EXECUTIVE DIRECTOR)
(301) 663-4130
Entity
Organization

Contact information

Practice address
5716 INDUSTRY LN STE C, FREDERICK, MD 21704-5202
(301) 663-4130
Mailing address
5716 INDUSTRY LN STE C, FREDERICK, MD 21704-5202
(301) 663-4130

Taxonomy

Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
903854
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
721210100
MD
Enumeration date
10/20/2011
Last updated
10/20/2011
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