Organization
BROOK LANE BEHAVIORAL SERVICES, INC.
Active
Other names
North Village
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA REPAC (CFO)
(301) 790-9351
Entity
Organization
Contact information
Practice address
18714 N VILLAGE, SHOPPING CENTER, HAGERSTOWN, MD 21742-2454
(301) 733-0330
(301) 733-4038
Mailing address
13121 BROOKLANE DR, HAGERSTOWN, MD 21742-1514
(301) 733-0331
(301) 733-4038
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
12391
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
698800800
—
MD
Enumeration date
01/31/2006
Last updated
02/17/2026
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