Organization
BROOK LANE BEHAVIORAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE LEA BARKDOLL (CRED COORDINATOR)
(301) 733-0331
Entity
Organization
Contact information
Practice address
5301 BUCKEYSTOWN PIKE, FREDERICK, MD 21704-8370
(301) 733-0330
(301) 733-4038
Mailing address
13121 BROOK LANE, HAGERSTOWN, MD 21742
(301) 733-0330
(301) 733-4038
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
BH000027
MD
Other
Enumeration date
04/25/2018
Last updated
10/01/2018
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