Organization
MAIN PLACE ADDICTION TREATMENT CENTER LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA MARIE GEYER (PROGRAM DIRECTOR)
(240) 575-1324
Entity
Organization
Contact information
Practice address
915 TOLL HOUSE AVE, FREDERICK, MD 21701-5930
(240) 575-1324
(301) 682-2053
Mailing address
365 W PATRICK ST STE 202, FREDERICK, MD 21701-4854
(240) 575-1324
(301) 682-2053
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
319411600
—
MD
Enumeration date
07/23/2014
Last updated
10/18/2016
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