POTOMAC RIDGE BEHAVORIAL HEALTH EASTERN SHORE (NPI# 1104952050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104952050 |
Entity Type | Organization |
Organization Name | POTOMAC RIDGE BEHAVORIAL HEALTH EASTERN SHORE |
Practice Address |
821 Fieldcrest Rd Cambridge MD 21613-9423 |
Practice Telephone | 4102210288 |
Practice Fax Number | 4102289588 |
Mailing Telephone | 4102210288 |
Mailing Fax Number | 4102289588 |
Enumeration Date | 2007-02-26 |
Last Update Date | 2008-06-23 |
Authorized Official Name | MISS CAROLYN F WITT (SCHOOL SOCIAL WORKER) |
Authorized Official Telephone | 4102210288 |
Authorized Official Credential | LCSW-C |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 10966 | MD | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MD | 410520600 | 05 | |
MD | 410978300 | 05 |
Street Address |
821 FIELDCREST RD |
City | CAMBRIDGE |
State | MD |
Zip Code | 21613-9423 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740227602 | Chesapeake Youth Center | Psychiatric Residential Treatment Facility | 821 Fieldcrest Rd, Cambridge, MD 21613-9423 | 2006-06-01 |
1518570274 | Avenues Recovery Center of Chesapeake Bay, LLC | Clinic/Center | 821 Fieldcrest Rd, Cambridge, MD 21613-9423 | 2020-08-24 |
1336752096 | Avenues Recovery Center of Chesapeake Bay, LLC | Clinic/Center | 821 Fieldcrest Rd, Cambridge, MD 21613-9423 | 2020-08-24 |
1821634098 | Avenues Recovery Center of Chesapeake Bay, LLC | Clinic/Center | 821 Fieldcrest Rd, Cambridge, MD 21613-9423 | 2019-11-22 |
1023445509 | Brittany Allison Cooper | Social Worker | 821 Fieldcrest Rd, Cambridge, MD 21613-9423 | 2013-09-30 |
1750717039 | Laura Marie Pyper | Social Worker | 821 Fieldcrest Rd, Cambridge, MD 21613-9423 | 2013-09-19 |
1003074980 | Potomac Ridge Behavioral Health Es | Psychiatric Hospital | 821 Fieldcrest Rd, Cambridge, MD 21613-9423 | 2008-05-28 |
1215107925 | Adventist Healthcare, Inc | Psychiatric Residential Treatment Facility | 821 Fieldcrest Rd, Cambridge, MD 21613-9423 | 2008-03-10 |
1942426911 | Potomac Ridge Behavioal Health Es | Chronic Disease Hospital | 821 Fieldcrest Rd, Cambridge, MD 21613-9423 | 2007-04-18 |
1053445247 | Potomac Ridge Behaviorial Health Eastern Shore | Residential Treatment Facility, Emotionally Disturbed Children | 821 Fieldcrest Rd, Cambridge, MD 21613-9423 | 2007-03-16 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225427289 | A Better Alternative Nursing Avency, Inc | Nursing Care | 204 Cedar Street, Canbridge, MD 21613 | 2015-01-14 |
1497048524 | Christina Marie Drostin | Family Medicine | 503 A Muir Street, Cambridge, MD 21613 | 2011-05-23 |
1841589058 | Wal-mart Stores East Lp | Technician/Technologist | 2775 Dorchester Square, Cambridge, MD 21613 | 2011-03-29 |
1053624452 | Gina Exantus-bernard | Pediatrics | 400 Byrn St Ste A, Cambridge, MD 21613 | 2010-07-14 |
1235362872 | St of Md/dhmh Dorchester Co Health Dept | Public Health or Welfare | 2475 Cambridge Bypass, Cambridge, MD 21613 | 2009-08-31 |
1801916622 | Alisha Foxwell Saulsbury | Social Worker | 208 Cedar St, Cambridge, MD 21613 | 2007-03-29 |
1497890669 | Charles Edmund Connelly Jr. | Dentist | 406 Lecompte Street, Cambridge, MD 21613 | 2007-02-21 |
1114088192 | Delmarva Community Services Inc | Nursing Care | 6210 Shiloh Church Hurlock Rd, Hurlock, MD 21613 | 2006-12-13 |
1184782658 | Lesa M Lee | Social Worker | 403 Race Street, Cambridge, MD 21613 | 2006-12-05 |
1750455747 | Jenny Lynne Jarrell | Social Worker | 208 Cedar Street, Cambridge, MD 21613 | 2006-11-20 |
Find all providers in zip 21613 |
Taxonomy Code | 322D00000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Emotionally Disturbed Children |
A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053445247 | Potomac Ridge Behaviorial Health Eastern Shore | Residential Treatment Facility, Emotionally Disturbed Children | 821 Fieldcrest Rd, Cambridge, MD 21613-9423 | 2007-03-16 |
1285765636 | Potomac Ridge- Eastern Shore | Residential Treatment Facility, Emotionally Disturbed Children | 821 Fieldcrest Rd, Cambridge, MD 21613-9423 | 2007-03-08 |
1700920527 | Potomac Ridge Behaviorial Health System Eastern Shore | Residential Treatment Facility, Emotionally Disturbed Children | 821 Fieldcrest Rd, Cambridge, MD 21613-9423 | 2007-02-16 |
1942344783 | Potomac Ridge Behaviorial Health Eastern Shore | Residential Treatment Facility, Emotionally Disturbed Children | 821 Fieldcrest Rd, Cambridge, MD 21613-9423 | 2007-02-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326219486 | North American Family Institute | Residential Treatment Facility, Emotionally Disturbed Children | 7960 Henryton Rd, Marriottsville, MD 21104-1103 | 2008-03-17 |
1508980251 | The House of The Good Shepherd of The City of Baltimore | Residential Treatment Facility, Emotionally Disturbed Children | 4100 Maple Avenue, Baltimore, MD 21227-4007 | 2007-03-19 |
1851480065 | Three Springs, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 20700 Wagoner Cutoff Road, Oldtown, MD 21555 | 2006-10-12 |
1255424164 | Sheppard Pratt Health System, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2940 Point of Rocks Rd., Jefferson, MD 21755-0009 | 2006-10-02 |
1033149257 | The Woodbourne Center, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1220b E Joppa Rd Ste 433, Towson, MD 21286-5819 | 2006-07-04 |
1104805696 | Regional Institute for Children and Adolescents - Southern Maryland | Residential Treatment Facility, Emotionally Disturbed Children | 9400 Surratts Rd, Cheltenham, MD 20623-1324 | 2006-01-12 |
1063402121 | Rica-baltimore | Residential Treatment Facility, Emotionally Disturbed Children | 605 S Chapel Gate Ln, Baltimore, MD 21229-3906 | 2005-10-28 |
1033101738 | John L. Gildner Regional Institute for Children and Adolescents | Residential Treatment Facility, Emotionally Disturbed Children | 15000 Broschart Rd, Rockville, MD 20850-3303 | 2005-08-18 |
1275614968 | Mann Rtc | Residential Treatment Facility, Emotionally Disturbed Children | 6501 N Charles St, Baltimore, MD 21204-6819 | 2006-10-18 |
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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.