Organization
DEPTMENT OF JUVENILE SERVICES
Active
Other names
Green Ridge Youth Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMMY LYNN FISHER (ADMINISTRATOR-CLINICAL SUPERVISOR)
(301) 478-3069
Entity
Organization
Contact information
Practice address
10700 15 MILE CRK ROAD, FLINTSTONE, MD 21530-3038
(301) 478-3069
(301) 478-3009
Mailing address
10700 15 MILE CRK ROAD, FLINTSTONE, MD 21530-3038
(301) 478-3069
(301) 478-3009
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/02/2007
Last updated
08/22/2020
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