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Organization

WALDEN SIERRA, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHARLES D WOOD (FINANCE DIRECTOR)
(301) 997-1300
Entity
Organization

Contact information

Practice address
26845 POINT LOOKOUT RD, LEONARDTOWN, MD 20650-4935
(301) 997-1300
(301) 997-1321
Mailing address
30007 BUSINESS CENTER DR, CHARLOTTE HALL, MD 20622-3101
(301) 997-1300
(301) 997-1321

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
901779
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
012240802
MD
05
745188100
MD
Enumeration date
01/24/2006
Last updated
10/26/2010
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