NPIMap

Organization Active NPI

Avery Halfway House

  • Substance Abuse Rehabilitation Facility
  • Rockville, MD
National Provider Identifier
1821071176
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
9217 Issued in MD
Legal business name
AVERY HALFWAY HOUSE
Practice address
14705 Avery Rd
Rockville, MD 20853-3605
Phone
(301) 762-4651
Fax
(301) 762-4836
NPI assigned
Nov 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Lorene Lake
Title
Executive Director
Phone
(410) 974-6829

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 9217 MD Primary

Addresses

Primary practice location

14705 Avery Rd
Rockville, MD 20853-3605

Mailing address

14705 Avery Rd
Rockville, MD 20853-3605
Phone (301) 762-4651

Other names 1

  • Chrysalis House Inc. Other name

National Provider Directory

National Provider Directory
Tax ID family
Avery Halfway House5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

14705 Avery Rd
Rockville, MD 20853
Phone (301) 762-4651

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821071176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14705 AVERY RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208533605",
            "telephone_number": "301-762-4651",
            "fax_number": "301-762-4836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14705 AVERY RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208533605",
            "telephone_number": "301-762-4651",
            "fax_number": "301-762-4836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERY HALFWAY HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAKE",
        "authorized_official_first_name": "LORENE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-974-6829"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MD",
            "license": "9217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chrysalis House Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.