Basic Information
| Provider Information | |||||||||
| NPI: | 1023341492 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WAY STATION INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 3826 | ||||||||
| Address2: | |||||||||
| City: | FREDERICK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016620099 | ||||||||
| FaxNumber: | 3016621071 | ||||||||
| Practice Location | |||||||||
| Address1: | 9030 ROUTE 108 | ||||||||
| Address2: | SUITE A | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210451951 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107401901 | ||||||||
| FaxNumber: | 4107408237 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2009 | ||||||||
| LastUpdateDate: | 09/16/2009 | ||||||||
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| AuthorizedOfficialLastName: | ROSE | ||||||||
| AuthorizedOfficialFirstName: | SCOTT | ||||||||
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| AuthorizedOfficialTitleorPosition: | C.E.O | ||||||||
| AuthorizedOfficialTelephone: | 3016620099 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.