NPIMap

Calvert Substance Abuse Services

Organization Active NPI Substance Abuse Rehabilitation Facility · Prince Frederick, MD

NPI 1629057484 · NPPES record last updated Nov 3, 2016

Key facts

NPI
1629057484
Entity type
Organization (NPI type 2)
Primary specialty
Substance Abuse Rehabilitation Facility 324500000X
License
12085 (MD)
Legal business name
CALVERT SUBSTANCE ABUSE SERVICES
Practice address
975 Solomons Island Rd N
Prince Frederick, MD 20678
Phone
(410) 535-5400
Fax
(410) 535-5285
NPI assigned
Jan 11, 2006
Reactivated
May 25, 2016
Organization subpart
No

Authorized official

Name
Ms. Doris J. McDonald, LCPC LCADC
Title
Director of Behavioral Health
Phone
(410) 535-3079

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Corporate family (same tax ID) 24

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

National Provider Directory

Tax ID family
Howard County Health de (83 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 12085 MD Yes

Addresses

Primary practice location

975 Solomons Island Rd N
Prince Frederick, MD 20678

Mailing address

PO Box 980
Prince Frederick, MD 20678
Phone (410) 535-5400

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 3, 2016.

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478131200000",
    "number": "1629057484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 980",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "20678",
            "telephone_number": "410-535-5400",
            "fax_number": "410-535-5285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 SOLOMONS ISLAND RD N",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "20678",
            "telephone_number": "410-535-5400",
            "fax_number": "410-535-5285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALVERT SUBSTANCE ABUSE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2016-11-03",
        "deactivation_date": "2014-07-18",
        "reactivation_date": "2016-05-25",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "DORIS",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "DIRECTOR OF BEHAVIORAL HEALTH",
        "authorized_official_telephone_number": "410-535-3079",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCPC LCADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MD",
            "license": "12085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

All providers in Prince Frederick, MD · Substance Abuse Rehabilitation Facility in Maryland

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