Organization
CORSICA RIVER MENTAL HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN F. PLASKON (EXECUTIVE DIRECTOR)
(410) 758-3050
Entity
Organization
Contact information
Practice address
502 POPLAR ST, CAMBRIDGE, MD 21613-1834
(443) 225-5780
(443) 225-5783
Mailing address
120 BANJO LN, P.O. BOX 718, CENTREVILLE, MD 21617-1002
(410) 758-2211
(410) 758-1223
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4214099 00
—
MD
Enumeration date
11/12/2012
Last updated
01/12/2013
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