Basic Information
| Provider Information | |||||||||
| NPI: | 1659584399 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEDICATION ASSISTED TREATMENT TECHNOLOGIES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 DIXIE DRIVE | ||||||||
| Address2: | |||||||||
| City: | BEL AIR | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4435675412 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1301 'C' LOFLIN ROAD | ||||||||
| Address2: | |||||||||
| City: | ABERDEEN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102739700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | TURNER | ||||||||
| AuthorizedOfficialFirstName: | NANCY | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4102739700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | RN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM2800X | AC0993 | MD | Y | Ambulatory Health Care Facilities | Clinic/Center | Methadone Clinic |
No ID Information.