Organization
MARYLAND TREATMENT CENTERS, INC.
Active
Other names
Mountain Manor Treatment Centers
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SARAH D. BOLEK (ASSOC DIR OF CONTRACTS)
(240) 401-3062
Entity
Organization
Contact information
Practice address
3800 FREDERICK AVE, BALTIMORE, MD 21229-3618
(410) 233-1400
(410) 233-5583
Mailing address
3800 FREDERICK AVE, BALTIMORE, MD 21229-3618
(410) 233-1400
(410) 233-5583
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
MD
2084P0800X
Psychiatry Physician
—
MD
2084P0802X
Addiction Psychiatry Physician
—
MD
2084P0804X
Child & Adolescent Psychiatry Physician
—
MD
251300000X
Local Education Agency (LEA)
3799
MD
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
14077
MD
261QM0850X
Adult Mental Health Clinic/Center
14077
MD
261QM0855X
Adolescent and Children Mental Health Clinic/Center
14077
MD
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
903139
MD
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
903143
MD
324500000X
Substance Abuse Rehabilitation Facility
Primary
903140
MD
3245S0500X
Children's Substance Abuse Rehabilitation Facility
903140
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039155700
—
MD
05
—
090501100
—
MD
05
—
203102700
—
MD
05
—
391090301
—
MD
05
—
510126302
—
MD
05
—
774502800
—
MO
Enumeration date
05/24/2006
Last updated
10/24/2025
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