Three Springs, Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

DJS LICENSE NO # Issued in MD

Legal business name

THREE SPRINGS, INC.

Practice address

20700 Wagoner Cutoff Road
Oldtown, MD 21555

Phone

(301) 478-5721

Fax

(301) 478-5723

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Brooke E Balch

Title

Cfo

Phone

(256) 880-3339

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• New Dominion Maryland Residential Treatment Program Other name

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267056000000",
    "number": "1851480065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8",
            "city": "OLDTOWN",
            "state": "MD",
            "postal_code": "215550008",
            "telephone_number": "301-478-5721",
            "fax_number": "301-478-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20700 WAGONER CUTOFF ROAD",
            "city": "OLDTOWN",
            "state": "MD",
            "postal_code": "21555",
            "telephone_number": "301-478-5721",
            "fax_number": "301-478-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE SPRINGS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2010-02-25",
        "status": "A",
        "authorized_official_last_name": "BALCH",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "256-880-3339",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "MD",
            "license": "DJS LICENSE NO #",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DJS CONTRACT",
            "identifier": "05-PD-042",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Dominion Maryland Residential Treatment Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ronald F Alves, PTA
• Sandra Burns
• Kimberly Ann Johnson
• Kasondra Lincoln
• Oldtown Volunteer Fire Department, Inc

• Emotionally Disturbed Childrens' Residential Treatment Facility in Oldtown, MD
• Providers in Oldtown, MD by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.