Organization
YOUTH CARE CENTER INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN JOHNSON (EXECUTIVE DIRECTOR)
(443) 944-1118
Entity
Organization
Contact information
Practice address
1504 S SALISBURY BLVD STE 22, SALISBURY, MD 21801-7165
(443) 914-2922
Mailing address
3917 MARKET ST, SNOW HILL, MD 21863-4413
(443) 914-2922
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
MD
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164806808
—
MD
05
—
1952823957
—
MD
Enumeration date
01/29/2018
Last updated
06/11/2019
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