| Bootsie Center, Llc | |
|
1925 Scientists Cliffs Rd Port Republic MD 20676-2405 | |
| (410) 474-6546 | |
| Not Available |
| Full Name | Bootsie Center, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1925 Scientists Cliffs Rd, Port Republic, Maryland |
| Authorized Official Name and Position | Rakeeda Commodore-jenkins (LCSW-C) |
| Authorized Official Contact | 4104746546 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bootsie Center, Llc 1925 Scientists Cliffs Rd Port Republic MD 20676-2405 Ph: (410) 474-6546 | Bootsie Center, Llc 1925 Scientists Cliffs Rd Port Republic MD 20676-2405 Ph: (410) 474-6546 |
| NPI Number | 1730903220 |
|---|---|
| Provider Enumeration Date | 11/11/2024 |
| Last Update Date | 11/11/2024 |
| Certification Date | 11/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730903220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
William J Stockton, M.d. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3405 Howard Dr, Port Republic, MD 20676 Phone: 443-295-7198 Fax: 443-295-7199 | |
Maple Consulting, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5623 Mills Field Ln, Port Republic, MD 20676 Phone: 410-586-8041 |