City Wide Treatment Center

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

CITY WIDE TREATMENT CENTER

Practice address

9104 Wipkey CT
Bowie, MD 20720-3233

Phone

(301) 464-9617

NPI assigned

Nov 5, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Damon Eugene Hall

Title

Ceo

Phone

(202) 409-7467

Specialties & licenses 4

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1063766558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9104 WIPKEY CT",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207203233",
            "telephone_number": "301-464-9617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9104 WIPKEY CT",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207203233",
            "telephone_number": "301-464-9617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY WIDE TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-05",
        "last_updated": "2012-11-05",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "DAMON",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-409-7467"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vincent Chukwuocha, LPN
• Zoobee Chukwurah
• Alexander Chung, D.D.S.
• Meg Victoria Cisse
• Bryan Drogin Citrenbaum
• Amanda Lyne Clark, MSW, LCSW-C
• Britney Renee Clark
• Grace D. Clark, PH.D.
• Jeannine Avis Clark, MD
• Chester Chatterton Clarke, MD

• Methadone Clinic in Bowie, MD
• Providers in Bowie, MD by specialty
• Methadone Clinic in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.