NPIMap

Organization Active NPI

Maryland Treatment Centers, Inc.

Doing business as Mountain Manor Treatment Centers

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1508811936
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
903140 Issued in MD
Legal business name
MARYLAND TREATMENT CENTERS, INC.
Doing business as
Mountain Manor Treatment Centers
Practice address
3800 Frederick Ave
Baltimore, MD 21229-3618
Phone
(410) 233-1400
Fax
(410) 233-5583
NPI assigned
May 24, 2006
Last updated
Oct 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Authorized official

Name
Ms. Sarah D. Bolek
Title
Assoc Dir of Contracts
Phone
(240) 401-3062

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 14077 MD
Adult Mental Health Clinic/Center 261QM0850X 14077 MD
Adolescent and Children Mental Health Clinic/Center 261QM0855X 14077 MD
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 903139 MD
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 903143 MD
Substance Abuse Rehabilitation Facility 324500000X 903140 MD Primary
Children's Substance Abuse Rehabilitation Facility 3245S0500X 903140 MD
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X MD
Psychiatry Physician 2084P0800X MD
Addiction Psychiatry Physician 2084P0802X MD
Child & Adolescent Psychiatry Physician 2084P0804X MD
Local Education Agency (LEA) 251300000X 3799 MD

Addresses

Primary practice location

3800 Frederick Ave
Baltimore, MD 21229-3618

Mailing address

3800 Frederick Ave
Baltimore, MD 21229-3618
Phone (410) 233-1400

Other identifiers 6

IdentifierTypeStateIssuer
391090301MedicaidMD
090501100MedicaidMD
203102700MedicaidMD
510126302MedicaidMD
774502800MedicaidMO
039155700MedicaidMD

Other names 1

  • Mountain Manor Treatment Centers Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Maryland Treatment Centers Inc42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

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

View all 41

Locations

3800 Frederick Ave
Baltimore, MD 21229
Phone (410) 233-1400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761264000000",
    "number": "1508811936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 FREDERICK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212293618",
            "telephone_number": "410-233-1400",
            "fax_number": "410-233-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 FREDERICK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212293618",
            "telephone_number": "410-233-1400",
            "fax_number": "410-233-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND TREATMENT CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A",
        "authorized_official_last_name": "BOLEK",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "ASSOC DIR OF CONTRACTS",
        "authorized_official_telephone_number": "240-401-3062",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MD",
            "license": "14077",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MD",
            "license": "14077",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MD",
            "license": "14077",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MD",
            "license": "903139",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MD",
            "license": "903143",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MD",
            "license": "903140",
            "primary": true
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "MD",
            "license": "903140",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "MD",
            "license": "3799",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "391090301",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090501100",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203102700",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "510126302",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "774502800",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039155700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Manor Treatment Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.