Organization
MONTGOMERY COUNTY MARYLAND GOVERNMENT
Active
Parent organization
MONTGOMERY COUNTY MARYLAND GOVERNMENT
Other names
Broad Acres School Based Health Clinic, Sbhc Broad Acres ES
Organization subpart
Yes
Provider details
NPI number
Legal business name
MONTGOMERY COUNTY MARYLAND GOVERNMENT
Authorized official
DIANA AZUCENA CORTEZ (MANAGEMENT)
(240) 672-6758
Entity
Organization
Contact information
Practice address
13313 OLD COLUMBIA PIKE, SILVER SPRING, MD 20904-5233
(240) 740-1902
(301) 431-4049
Mailing address
401 HUNGERFORD DR FL 6, ROCKVILLE, MD 20850-4154
(240) 777-4520
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420869202
—
MD
Enumeration date
03/30/2007
Last updated
04/30/2026
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