NPIMap

Organization Active NPI

Place for Change

  • Substance Abuse Rehabilitation Facility
  • Reisterstown, MD
National Provider Identifier
1477917979
Registry record updated Apr 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
PLACE FOR CHANGE
Practice address
117 Maple Ridge Rd
Reisterstown, MD 21136-6518
Phone
(410) 370-8544
NPI assigned
Apr 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2016

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

Authorized official

Name
Theresa Thomas, ASA-AD
Title
Clinical Director
Phone
(410) 370-8544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

117 Maple Ridge Rd
Reisterstown, MD 21136-6518

Mailing address

117 Maple Ridge Rd
Reisterstown, MD 21136-6518
Phone (410) 370-8544

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460332800000",
    "number": "1477917979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 MAPLE RIDGE RD",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211366518",
            "telephone_number": "410-370-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 MAPLE RIDGE RD",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211366518",
            "telephone_number": "410-370-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLACE FOR CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-11",
        "last_updated": "2016-04-11",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "410-370-8544",
        "authorized_official_credential": "ASA-AD"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reisterstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.