Provider Demographics
NPI:1528740628
Name:NATIONAL CAPITAL TREATMENT AND RECOVERY-MARYLAND
Entity type:Organization
Organization Name:NATIONAL CAPITAL TREATMENT AND RECOVERY-MARYLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-825-8762
Mailing Address - Street 1:200 N GLEBE RD STE 104
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-3755
Mailing Address - Country:US
Mailing Address - Phone:703-841-0703
Mailing Address - Fax:
Practice Address - Street 1:2503 VIOLET AVE FL 6
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-7700
Practice Address - Country:US
Practice Address - Phone:703-841-0703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL CAPITAL TREATMENT AND RECOVERY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty