NPIMap

Organization Active NPI

Rock Creek Foundation for Mental Health Inc

  • Developmental Disabilities Clinic/Center
  • Lanham, MD
National Provider Identifier
1205615739
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
ROCK CREEK FOUNDATION FOR MENTAL HEALTH INC
Practice address
4355 Nicole Dr Ste E
Lanham, MD 20706-4349
Phone
(301) 586-0900
Fax
(240) 516-0391
NPI assigned
Sep 25, 2023
Last updated
Sep 26, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
AFFILIATED SANTE GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Authorized official

Name
Theresa Antionette Jackson
Title
A/R Billing Coordinator
Phone
(301) 586-0900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

4355 Nicole Dr Ste E
Lanham, MD 20706-4349

Mailing address

12200 Tech Rd Ste 330
Silver Spring, MD 20904-1913
Phone (301) 586-0900

National Provider Directory

National Provider Directory
Tax ID family
Rock Creek Foundation for Mental Health Inc6 organizations share this tax ID, including this one
Part of
Asg

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4355 Nicole Dr
Ste E
Lanham, MD 20706
Phone (301) 586-0900

NPI Registry JSON

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1205615739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 TECH RD STE 330",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041913",
            "telephone_number": "301-586-0900",
            "fax_number": "240-516-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4355 NICOLE DR STE E",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207064349",
            "telephone_number": "301-586-0900",
            "fax_number": "240-516-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK CREEK FOUNDATION FOR MENTAL HEALTH INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AFFILIATED SANTE GROUP",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "ANTIONETTE",
        "authorized_official_title_or_position": "A/R BILLING COORDINATOR",
        "authorized_official_telephone_number": "301-586-0900"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.