Organization
MARYLAND TREATMENT CENTERS, INC.
Active
Other names
Avery Road Combined Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM J. ROBY MBA (EXECUTIVE VICE PRESIDENT)
(301) 447-2361
Entity
Organization
Contact information
Practice address
14701 AVERY RD, ROCKVILLE, MD 20853-3605
(301) 279-8828
(301) 279-8910
Mailing address
14701 AVERY RD, ROCKVILLE, MD 20853-3605
(301) 279-8828
(301) 279-8910
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
MH484
MD
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
904068
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090501105
—
MD
05
—
510126300
—
MD
05
—
PENDING
—
MD
Enumeration date
03/03/2011
Last updated
03/03/2011
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