NPIMap

Organization Active NPI

Glass Health Programs, Inc.

Doing business as MedMark Treatment Centers - Essex

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Essex, MD
National Provider Identifier
1598021917
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
904656 Issued in MD
Legal business name
GLASS HEALTH PROGRAMS, INC.
Doing business as
MedMark Treatment Centers - Essex
Practice address
8909 Kelso Dr
Essex, MD 21221-3113
Phone
(410) 486-2500
Fax
(410) 780-8686
NPI assigned
Apr 10, 2012
Last updated
Jul 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Bruce Jarvie
Title
VP, Treasurer
Phone
(214) 379-3300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X 905602 MD
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 904656 MD Primary

Addresses

Primary practice location

8909 Kelso Dr
Essex, MD 21221-3113

Mailing address

1720 Lakepointe Dr Ste 117
Lewisville, TX 75057-6425
Phone (214) 379-3300

Other identifiers 2

IdentifierTypeStateIssuer
905602OtherMDDHMH
03919103MedicaidMD

Other names 1

  • MedMark Treatment Centers - Essex Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Opioid treatment program
Medicare-enrolled since Aug 17, 2022

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200219002039 MD Part B Supplier - Opioid Treatment Program (Otp) 7719314475 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Baltimore, MD; Belcamp, MD; Essex, MD; Timonium, MD

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Glass Health Programs Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1598021917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 LAKEPOINTE DR STE 117",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576425",
            "telephone_number": "214-379-3300",
            "fax_number": "214-853-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8909 KELSO DR",
            "city": "ESSEX",
            "state": "MD",
            "postal_code": "212213113",
            "telephone_number": "410-486-2500",
            "fax_number": "410-780-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLASS HEALTH PROGRAMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-10",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "JARVIE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "VP, TREASURER",
        "authorized_official_telephone_number": "214-379-3300"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "MD",
            "license": "905602",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MD",
            "license": "904656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHMH",
            "identifier": "905602",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03919103",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedMark Treatment Centers - Essex",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Essex, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.