NPIMap

Organization Active NPI

Glass Health Programs, Inc.

Doing business as MedMark Treatment Centers - Belcamp

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Belcamp, MD
National Provider Identifier
1689937260
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
GLASS HEALTH PROGRAMS, INC.
Doing business as
MedMark Treatment Centers - Belcamp
Practice address
1361 Brass Mill Rd
Suite a
Bel Camp, MD 21017
Phone
(410) 273-9700
Fax
(410) 273-9713
NPI assigned
Jun 19, 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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X MD
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X MD Primary
Community/Behavioral Health Agency 251S00000X 101202 MD

Addresses

Primary practice location

1361 Brass Mill Rd
Suite a
Bel Camp, MD 21017

Mailing address

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

Other identifiers 4

IdentifierTypeStateIssuer
403453800MedicaidMD
905637OtherMDLICENSE
0019661780001MedicaidPA
39191306MedicaidMD

Other names 1

  • MedMark Treatment Centers - Belcamp 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
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.

Locations

1361 Brass Mill Rd
Ste A
Belcamp, MD 21017
Phone (410) 273-9700

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1689937260",
    "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": "1361 BRASS MILL RD",
            "address_2": "SUITE A",
            "city": "BEL CAMP",
            "state": "MD",
            "postal_code": "21017",
            "telephone_number": "410-273-9700",
            "fax_number": "410-273-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLASS HEALTH PROGRAMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-19",
        "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": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MD",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "101202",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403453800",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "905637",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019661780001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39191306",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedMark Treatment Centers - Belcamp",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belcamp, 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.