NPIMap

Organization Active NPI

Walden Sierra, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Leonardtown, MD
National Provider Identifier
1598735409
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
901779 Issued in MD
Legal business name
WALDEN SIERRA, INC.
Practice address
26845 Point Lookout Rd
Leonardtown, MD 20650-4935
Phone
(301) 997-1300
Fax
(301) 997-1321
NPI assigned
Jan 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

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

Authorized official

Name
Mr. Charles D Wood
Title
Finance Director
Phone
(301) 997-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 901779 MD Primary

Addresses

Primary practice location

26845 Point Lookout Rd
Leonardtown, MD 20650-4935

Mailing address

30007 Business Center Dr
Charlotte Hall, MD 20622-3101
Phone (301) 997-1300

Other identifiers 2

IdentifierTypeStateIssuer
745188100MedicaidMD
012240802MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Walden Sierra7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1138060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288051200000",
    "number": "1598735409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30007 BUSINESS CENTER DR",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "206223101",
            "telephone_number": "301-997-1300",
            "fax_number": "301-997-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26845 POINT LOOKOUT RD",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206504935",
            "telephone_number": "301-997-1300",
            "fax_number": "301-997-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALDEN SIERRA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-24",
        "last_updated": "2010-10-26",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "301-997-1300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MD",
            "license": "901779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "745188100",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012240802",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leonardtown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; 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.