Organization
PAIN AND SPINE SPECIALISTS OF MARYLAND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACI POWELL (BILLING MANAGER)
(301) 703-8767
Entity
Organization
Contact information
Practice address
6816 DEERPATH RD STE 201, ELKRIDGE, MD 21075-6200
(301) 703-8767
Mailing address
2702 BACK ACRE CIR STE 290B, MOUNT AIRY, MD 21771-7769
(301) 703-8767
(301) 703-8886
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
03/13/2020
Last updated
03/13/2020
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