Organization
MARYLAND TREATMENT CENTERS, INC.
Active
Other names
Mountain Manor Treatment Centers
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SARAH D BOLEK (ASSOC DIR CONTRACTS)
(240) 401-3062
Entity
Organization
Contact information
Practice address
174 THOMAS JOHNSON DR STE 101-102, FREDERICK, MD 21702-4423
(301) 662-1407
(301) 662-6989
Mailing address
174 THOMAS JOHNSON DR STE 101-102, FREDERICK, MD 21702-4423
(301) 662-1407
(301) 662-6989
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
903869
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
510126303
—
MD
Enumeration date
10/10/2006
Last updated
10/24/2025
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