CALVERT SUBSTANCE ABUSE SERVICES (NPI# 1629057484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629057484 |
| Entity Type | Organization |
| Organization Name | CALVERT SUBSTANCE ABUSE SERVICES |
| Practice Address |
975 Solomons Island Rd N Prince Frederick MD 20678 |
| Mailing Address |
Po Box 980 Prince Frederick MD 20678 |
| Practice Telephone | 4105355400 |
| Practice Fax Number | 4105355285 |
| Mailing Telephone | 4105355400 |
| Mailing Fax Number | 4105355285 |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2016-11-03 |
| NPI Deactivation Date | 07/18/2014 |
| NPI Reactivation Date | 2016-05-25 |
| Authorized Official Name | MS. DORIS J. MCDONALD (DIRECTOR OF BEHAVIORAL HEALTH) |
| Authorized Official Telephone | 4105353079 |
| Authorized Official Credential | LCPC LCADC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 12085 | MD | Residential Treatment Facilities |
| Street Address |
975 SOLOMONS ISLAND RD N |
| City | PRINCE FREDERICK |
| State | MD |
| Zip Code | 20678 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841843224 | Jennifer Faulkner | Health Educator | 975 Solomons Island Rd N, Prince Frederick, MD 20678-3917 | 2019-07-24 |
| 1740848423 | Calvert County Health Department | Health Educator | 975 Solomons Island Rd N, Prince Frederick, MD 20678-3917 | 2019-05-29 |
| 1922573534 | Emma-ann Nowak | Social Worker | 975 Solomons Island Rd N, Prince Frederick, MD 20678-3917 | 2018-10-10 |
| 1659853661 | Jacqueline Lenore Waul | Student in an Organized Health Care Education/Training Program | 975 Solomons Island Rd N, Prince Frederick, MD 20678-3917 | 2018-09-06 |
| 1710469564 | Torrey Rachelle Shipman | Student in an Organized Health Care Education/Training Program | 975 Solomons Island Rd N, Prince Frederick, MD 20678-3917 | 2018-08-29 |
| 1235625096 | Carrie Marie White | Registered Nurse | 975 Solomons Island Rd N, Prince Frederick, MD 20678-3917 | 2018-07-05 |
| 1164916441 | Amanda Kurtz | Social Worker | 975 Solomons Island Rd N, Prince Frederick, MD 20678-3917 | 2018-06-19 |
| 1659868271 | Katelynn Mae Liptak | Social Worker | 975 Solomons Island Rd N, Prince Frederick, MD 20678-3917 | 2018-04-19 |
| 1144747056 | Allison Lorraine Krichbaum | Counselor | 975 Solomons Island Rd N, Prince Frederick, MD 20678-3917 | 2017-08-23 |
| 1497280952 | Chelsea Tarleton | Social Worker | 975 Solomons Island Rd N, Prince Frederick, MD 20678-3917 | 2017-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861857500 | Watershed Counseling Service | Counselor | 246 Merrimac Court, Prince Frederick, MD 20678 | 2015-12-23 |
| 1023449642 | Mary Gordon Walter | Registered Nurse | 976 Solomans Island Road, Prince Frederick, MD 20678 | 2013-12-07 |
| 1891126827 | Jacqueline Leclercq | Nurse Practitioner | 110 Hospital Road Suite 303, Prince Frederick, MD 20678 | 2013-12-02 |
| 1174959001 | Linsey Rowe Heane | Physical Therapist | 110 Main Street Suite 1, Prince Frederick, MD 20678 | 2013-09-24 |
| 1053607002 | Tidewater Dental Pf | Dentist | 690 Prince Frederick Blvd, Prince Frederick, MD 20678 | 2011-06-28 |
| 1033411558 | Sharon Patricia Parran | Pharmacist | 80 W.dares Beach Road, Prince Frederick, MD 20678 | 2010-12-04 |
| 1366684326 | Prince Frederick Surgery Center LLC | Clinic/Center | 70 Sherry Lane, Suite 101, Prince Frederick, MD 20678 | 2009-04-06 |
| 1982844734 | Orthocare Solutions Inc | Durable Medical Equipment & Medical Supplies | 220 Old Solomans Island Rd, Prince Frederick, MD 20678 | 2009-03-05 |
| 1225273519 | Rebecca Lynn Jahed | Audiologist | 3180 Blackberry Lane, Prince Frederick, MD 20678 | 2008-12-16 |
| 1669639209 | Ralph Walter Niemann | Dentist | 272 Merrimac Court, Prince Frederick, MD 20678 | 2008-05-21 |
| Find all providers in zip 20678 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902955396 | Dwi Services, Inc | Substance Abuse Rehabilitation Facility | 125 Fairgrounds Road, Prince Frederick, MD 20678-0730 | 2007-01-09 |
| 1619403821 | Dwi Services Inc | Substance Abuse Rehabilitation Facility | 125 Fairground Rd, Prince Frederick, MD 20678-4167 | 2017-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477151066 | Evolve Residential, LLC | Substance Abuse Rehabilitation Facility | 486 Lincoln Dr, Glen Burnie, MD 21060-8706 | 2020-10-15 |
| 1841898434 | Evolve Residential, LLC | Substance Abuse Rehabilitation Facility | 394 Washington Ave, Glen Burnie, MD 21060-8712 | 2020-10-15 |
| 1942808050 | Powell Recovery Center, Inc. | Substance Abuse Rehabilitation Facility | 10 S Broadway, Baltimore, MD 21231-1775 | 2020-10-12 |
| 1396343414 | Powell Recovery Center, Inc. | Substance Abuse Rehabilitation Facility | 15 S Broadway, Baltimore, MD 21231-1714 | 2020-10-12 |
| 1801494984 | Evolve Residential, LLC | Substance Abuse Rehabilitation Facility | 8315 Veterans Hwy, Millersville, MD 21108-1421 | 2020-10-12 |
| 1124626296 | Evolve Residential, LLC | Substance Abuse Rehabilitation Facility | 390 Washington Ave, Glen Burnie, MD 21060-8712 | 2020-10-12 |
| 1457968984 | Powell Recovery Center | Substance Abuse Rehabilitation Facility | 22 S Broadway, Baltimore, MD 21231-1711 | 2020-09-29 |
| 1356956676 | The Elysian Fields Optimum Wellness and Mental Health Group, LLC | Substance Abuse Rehabilitation Facility | 2901 Erdman Ave, Baltimore, MD 21213-1139 | 2020-09-14 |
| 1134731284 | Serenity Keepers of Maryland LLC | Substance Abuse Rehabilitation Facility | 3645 Cottage Ave, Baltimore, MD 21215-7725 | 2020-08-20 |
| 1255949392 | Champ House Recovery Inc. | Substance Abuse Rehabilitation Facility | 8655 Normal School Rd, Bowie, MD 20715-3326 | 2020-07-15 |
| Find all providers with the same taxonomy | ||||
| City | PRINCE FREDERICK |
| Zip Code | 20678 |
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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.