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Organization

MONTGOMERY COUNTY MARYLAND GOVERNMENT

Active
Other names
Seneca Valley School Based Wellness Center
Organization subpart
No

Provider details

NPI number
Authorized official
DIANA AZUCENA CORTEZ (MANAGEMENT)
(240) 672-6758
Entity
Organization

Contact information

Practice address
19401 CRYSTAL ROCK DR, GERMANTOWN, MD 20874-1593
(240) 740-6402
Mailing address
19401 CRYSTAL ROCK DR, GERMANTOWN, MD 20874-1593
(240) 740-6402

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
261QS1000X
Student Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
123456789
MD
Enumeration date
06/14/2021
Last updated
09/11/2025
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