ALLEGANY COUNTY HEALTH DEPARTMENT (NPI# 1134512403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134512403 |
| Entity Type | Organization |
| Organization Name | ALLEGANY COUNTY HEALTH DEPARTMENT |
| Other Organization Name | BEHAVIORAL HEALTH JACKSON UNIT |
| Practice Address |
10102 Country Club Rd Se Cumberland MD 21502-8339 |
| Mailing Address |
Po Box 1745 Cumberland MD 21501-1745 |
| Practice Telephone | 3017772290 |
| Practice Fax Number | 3017772141 |
| Mailing Telephone | 3017595000 |
| Mailing Fax Number | 3017775674 |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2015-03-11 |
| Authorized Official Name | DR. SUE V RAVER (ALLEGANY COUNTY HEALTH OFFICER) |
| Authorized Official Telephone | 3017595000 |
| Authorized Official Credential | M.D., M.P.H. |
| Is Organization Subpart | Y |
| Parent Organization Name | ALLEGANY COUNTY HEALTH DEPARTMENT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
904691 | MD | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VALUE OPTIONS | 323817 | 01 | |
| MAMSI | 277593 | 01 | |
| MD | 603304100 | 05 |
| Other Name | Type Code |
|---|---|
| Behavioral Health Jackson Unit | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790260941 | Allegany County Health Department | Substance Abuse Rehabilitation Facility | 12300 Old Willow Brk Rd Se, Cumberland, MD 21502-8342 | 2018-10-03 |
| 1114364544 | Allegany County Health Department | Early Intervention Provider Agency | 7 Court Street County Office Complex, Ground Floor Room 13, Belmont, NY 14813-1044 | 2013-05-24 |
| 1811197502 | Allegany County Health Department | Substance Abuse Rehabilitation Facility | 10102 Country Club Rd, Cumberland, MD 21502 | 2007-07-20 |
| 1639293228 | Allegany County Health Department | Clinic/Center | 12503 Willowbrook Rd, Cumberland, MD 21502-2554 | 2007-03-19 |
| 1265556815 | Allegany County Health Department | Community/Behavioral Health | 12501- 12503 Willowbrook Rd, Cumberland, MD 21502-2569 | 2007-03-19 |
| 1376059519 | Allegany County Health Department | Case Management | 12501 Willowbrook Rd, Cumberland, MD 21502-2569 | 2017-12-26 |
| 1821528332 | Allegany County Health Department | Substance Abuse Rehabilitation Facility | 10102 Country Club Rd Se, Cumberland, MD 21502 | 2017-06-16 |
| 1043600794 | Allegany County Health Department | Community/Behavioral Health | 12503 Willowbrook Rd, Cumberland, MD 21502-2554 | 2015-02-03 |
| 1265838635 | Allegany County Health Department | Community/Behavioral Health | 12501 Willowbrook Rd, Cumberland, MD 21502-2569 | 2014-11-13 |
| 1770852675 | Allegany County Health Department | Clinic/Center | 12501 Willowbrook Rd, Cumberland, MD 21502-2569 | 2011-12-21 |
| Street Address |
10102 COUNTRY CLUB RD SE |
| City | CUMBERLAND |
| State | MD |
| Zip Code | 21502-8339 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740275106 | Comptroller of Maryland Central Payroll Bureau | Psychiatric Hospital | 10102 Country Club Rd Se, Cumberland, MD 21502-8339 | 2005-09-13 |
| 1609475201 | Tara Lynne Garner-delzell | Counselor | 10102 Country Club Rd Se, Cumberland, MD 21502-8339 | 2020-10-23 |
| 1629689245 | Mikali Rain Artice | Counselor | 10102 Country Club Rd Se, Cumberland, MD 21502-8339 | 2020-08-17 |
| 1881203115 | Jennifer Hart | Licensed Practical Nurse | 10102 Country Club Rd Se, Cumberland, MD 21502-8339 | 2020-07-22 |
| 1255965802 | Carly Ann Mccormick | Counselor | 10102 Country Club Rd Se, Cumberland, MD 21502-8339 | 2020-02-22 |
| 1487290102 | Ashley Jean Elliott | Counselor | 10102 Country Club Rd Se, Cumberland, MD 21502-8339 | 2019-11-19 |
| 1396393229 | Tina Mills | Registered Nurse | 10102 Country Club Rd Se, Cumberland, MD 21502-8339 | 2019-09-04 |
| 1427607365 | Donnie Painter | Registered Nurse | 10102 Country Club Rd Se, Cumberland, MD 21502-8339 | 2019-09-04 |
| 1609433853 | James Painter | Registered Nurse | 10102 Country Club Rd Se, Cumberland, MD 21502-8339 | 2019-05-23 |
| 1801372339 | Deann Mccloud | Counselor | 10102 Country Club Rd Se, Cumberland, MD 21502-8339 | 2018-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174141592 | Upmc Western Maryland Corporation | Clinic/Center | 10700 Leslie Lane, Cumberland, MD 21502 | 2020-07-13 |
| 1669934212 | Ultimate Hearing Solutions Vi, LLC | Durable Medical Equipment & Medical Supplies | 701 Park Street, Queen City Centre, Cumberland, MD 21502 | 2019-04-03 |
| 1114497070 | Dianne Liller | Speech-Language Pathologist | 200 Massachusetts Ave, Cumberland, MD 21502 | 2018-12-04 |
| 1386111409 | Rebecca Anne Stewart | Counselor | 217 Glenn Street, Suite 401, Cumberland, MD 21502 | 2018-10-26 |
| 1396222998 | Crystal Lynne Walls | Nurse Practitioner | Western Maryland Health System, 12500 Willowbrook Rd, Cumberland, MD 21502 | 2018-07-26 |
| 1841796554 | Joan Kathleen Hoban | Speech-Language Pathologist | Potomac Behavioral and Occupational Therapy, 240 Henderson Ave., Cumberland, MD 21502 | 2018-04-02 |
| 1760984447 | Christine T. Haines | Social Worker | 907 Seton Drive, Cumberland, MD 21502 | 2018-03-08 |
| 1033632328 | Nicole Mabury | Counselor | 12501 Willowbrook Road, Cumberland, MD 21502 | 2017-07-19 |
| 1073042479 | The Lions Center for Rehabilitation and Extended Care, Inc. | Skilled Nursing Facility | 901 Seton Drive, Cumberland, MD 21502 | 2017-06-08 |
| 1912446816 | Marina Hurst | Counselor | 10102 County Club Road Se, Cumberland, MD 21502 | 2017-02-13 |
| Find all providers in zip 21502 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942360490 | Allegany County Health Department | Substance Abuse Rehabilitation Facility | 10102 Country Club Rd Se, Cumberland, MD 21502-8339 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821697640 | Peaceful Minds Residential Services | Substance Abuse Rehabilitation Facility | 3704 S Hanover St, Baltimore, MD 21225-1773 | 2020-10-22 |
| 1215548573 | Peaceful Minds Residential Services | Substance Abuse Rehabilitation Facility | 3704 S Hanover St Unit 2a2b, Baltimore, MD 21225-1773 | 2020-08-11 |
| 1093332595 | A Brighter Day Behavioral Health Center | Substance Abuse Rehabilitation Facility | 8350 Bristol Ct Ste 101, Jessup, MD 20794-9756 | 2020-06-30 |
| 1497316715 | Center for Creative Values, Inc | Substance Abuse Rehabilitation Facility | 8110 Harford Road, Suite B, Parkville, MD 21234-2123 | 2019-06-26 |
| 1255875753 | Contemporary Family Services, Inc | Substance Abuse Rehabilitation Facility | 6525 Belcrest Rd., G40, Hyattsville, MD 20782-2003 | 2016-12-19 |
| 1356694277 | One World Foundation | Substance Abuse Rehabilitation Facility | 807 Balsamtree Dr, Capitol Heights, MD 20743-1427 | 2012-10-16 |
| 1932334406 | Victor Cullen Center | Substance Abuse Rehabilitation Facility | 6000 Cullen Dr, Sabillasville, MD 21780-9701 | 2009-05-27 |
| 1316115454 | Second Genesis, Inc | Substance Abuse Rehabilitation Facility | 4620 Melwood Rd, Upper Marlboro, MD 20772-9507 | 2008-02-12 |
| 1538355524 | Meadow Mountain Drug Treatment Program | Substance Abuse Rehabilitation Facility | 234 Recovery Rd, Grantsville, MD 21536-2217 | 2007-09-24 |
| 1124223979 | Collington Square Non Profit Corporation | Substance Abuse Rehabilitation Facility | 1211 N Chester St, Baltimore, MD 21213-3330 | 2007-06-20 |
| Find all providers with the same taxonomy | ||||
| City | CUMBERLAND |
| Zip Code | 21502 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.