Organization
BROOK LANE HEALTH SERVICES
Active
Other names
Chronic Onsite
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTY POFFENBERGER (COORDINATOR/MANAGED CARE)
(301) 733-0331
Entity
Organization
Contact information
Practice address
13215 BROOK LANE, HAGERSTOWN, MD 21742-1514
(301) 733-0330
(301) 733-4038
Mailing address
13215 BROOK LANE, HAGERSTOWN, MD 21742-1435
(301) 733-0330
(301) 733-4038
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
21-002
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
986965400
—
MD
Enumeration date
02/21/2006
Last updated
09/06/2022
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