CCHD - SUBSTANCE ABUSE SRVCS - BARSTOW (NPI# 1417936287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417936287 |
| Entity Type | Organization |
| Organization Name | CCHD - SUBSTANCE ABUSE SRVCS - BARSTOW |
| Practice Address |
280 Stafford Road Barstow MD 20610 |
| Mailing Address |
P.o. Box 1158 Prince Frederick MD 20678 |
| Practice Telephone | 4105353079 |
| Practice Fax Number | 4105352220 |
| Mailing Telephone | 4105353079 |
| Mailing Fax Number | 4105352220 |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2015-07-10 |
| Authorized Official Name | MRS. DORIS J. MCDONALD (BEHAVIORAL HEALTH DIRECTOR) |
| Authorized Official Telephone | 4105353079 |
| Authorized Official Credential | MA, LCADC, LCDC |
| Is Organization Subpart | Y |
| Parent Organization Name | CALVERT SUBSTANCE ABUSE SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 12086 | MD | Residential Treatment Facilities |
| Street Address |
280 STAFFORD ROAD |
| City | BARSTOW |
| State | MD |
| Zip Code | 20610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609424852 | Casey Lynn Vendetti | Social Worker | 280 Stafford Road, Barstow, MD 20610 | 2019-08-30 |
| 1598285660 | Calvert County Health Department | Clinic/Center | 280 Stafford Road, Barstow, MD 20610 | 2017-06-21 |
| 1912355637 | Calvert County Health Department | Clinic/Center | 280 Stafford Road, Barstow, MD 20610 | 2016-06-03 |
| 1194120758 | Amanda Cipriani | Social Worker | 280 Stafford Road, Barstow, MD 20610 | 2014-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326027194 | Calvert County Jail Substance Abuse Prgm | Substance Abuse Rehabilitation Facility | 315 Stafford Road, Barstow, MD 20610 | 2006-01-11 |
| 1891349148 | Jayda Keyerra Blount | Counselor | 280 Stafford Rd, Barstow, MD 20610 | 2019-07-25 |
| 1023584786 | Belinda Barber | Social Worker | 280 Stafford Rd, Barstow, MD 20610 | 2018-10-22 |
| 1811413735 | Jesse Tiralla | Social Worker | 280 Stafford Rd, Barstow, MD 20610 | 2017-08-22 |
| 1962916817 | Shana Nicole Grimes | Social Worker | 325 Stafford Rd, Barstow, MD 20610-2061 | 2017-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144829516 | Qunieca Robertson | Behavior Technician | 755 E Virginia Way Apt 90, Barstow, CA 92311-3962 | 2020-10-18 |
| 1447860630 | Shaunte T Johnson | Behavior Technician | 411 Juniper St Apt A, Barstow, CA 92311-4994 | 2020-08-03 |
| 1609484393 | Jennifer James | Non-emergency Medical Transport (VAN) | 1900 Dill Rd Apt 49, Barstow, CA 92311-5666 | 2020-07-19 |
| 1912529074 | High Desert Community Home Health Inc | Home Health | 222 E Main St Ste 216, Barstow, CA 92311-2366 | 2020-05-12 |
| 1043844459 | Nickolas Sloan Huston | Psychologist | 2371 W Main St Spc 57, Barstow, CA 92311-3614 | 2020-02-24 |
| 1568013209 | Rosemarie Johnson | Technician | 480 Armory Rd, Barstow, CA 92311-4932 | 2019-09-24 |
| 1972154854 | Gabriela Molina | Technician | 27817 Apache Ave, Barstow, CA 92311-4368 | 2019-09-23 |
| 1497227730 | Angelic Touch Homecare 1services Inc. | Home Health | 1501 Nancy St, Barstow, CA 92311-2534 | 2018-12-27 |
| 1457822157 | Bommireddy Vishwas Reddy | Naturopath | 35190 Marks Rd, Barstow, CA 92311-2039 | 2018-12-06 |
| 1831678465 | Martina Nuhu Kashalla | Nurse Practitioner | 332 Date Ave, Barstow, CA 92311-5548 | 2018-08-14 |
| Find all providers in BARSTOW | ||||
| 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 |
|---|---|---|---|---|
| 1205222536 | American Health Services LLC | Substance Abuse Rehabilitation Facility | 234/236, 300, 304 and 308e Fredricks Street, Barstow, CA 92311 | 2015-04-14 |
| 1437288131 | Vista Guidance Centers, Inc. | Substance Abuse Rehabilitation Facility | 236 E Fredricks St, Barstow, CA 92311-2821 | 2007-03-06 |
| 1326027194 | Calvert County Jail Substance Abuse Prgm | Substance Abuse Rehabilitation Facility | 315 Stafford Road, Barstow, MD 20610 | 2006-01-11 |
| 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 | ||||
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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.