NPIMap

Organization Active NPI

Maryland Treatment Centers, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Frederick, MD
National Provider Identifier
1730277435
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
903869 Issued in MD
Legal business name
MARYLAND TREATMENT CENTERS, INC.
Doing business as
Mountain Manor Treatment Centers
Practice address
174 Thomas Johnson Dr Ste 101-102
Frederick, MD 21702-4423
Phone
(301) 662-1407
Fax
(301) 662-6989
NPI assigned
Oct 10, 2006
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 Contracts
Phone
(240) 401-3062

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 903869 MD Primary

Addresses

Primary practice location

174 Thomas Johnson Dr Ste 101-102
Frederick, MD 21702-4423

Mailing address

174 Thomas Johnson Dr Ste 101-102
Frederick, MD 21702-4423
Phone (301) 662-1407

Other identifiers 1

IdentifierTypeStateIssuer
510126303MedicaidMD

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

174 Thomas Johnson Dr
Ste 102
Frederick, MD 21702
Phone (301) 682-6261

174 Thomas Johnson Dr
Ste 101102
Frederick, MD 21702
Phone (301) 662-1407

174 Thomas Johnson Dr
Ste 101
Frederick, MD 21702
Phone (301) 620-1692

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761264000000",
    "number": "1730277435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 THOMAS JOHNSON DR STE 101-102",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024423",
            "telephone_number": "301-662-1407",
            "fax_number": "301-662-6989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 THOMAS JOHNSON DR STE 101-102",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024423",
            "telephone_number": "301-662-1407",
            "fax_number": "301-662-6989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND TREATMENT CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "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 CONTRACTS",
        "authorized_official_telephone_number": "240-401-3062",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MD",
            "license": "903869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "510126303",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Manor Treatment Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Frederick, 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.