| Ccs Millersville - Medicaid Facility | |
|
8638 Veterans Hwy Ste 301 Millersville MD 21108-1422 | |
| (410) 740-8066 | |
| (410) 740-8068 |
| Full Name | Ccs Millersville - Medicaid Facility |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 8638 Veterans Hwy Ste 301, Millersville, Maryland |
| Authorized Official Name and Position | Mark David Donovan (CEO) |
| Authorized Official Contact | 4107408066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ccs Millersville - Medicaid Facility 10630 Little Patuxent Pkwy Ste 209 Columbia MD 21044-6278 Ph: (410) 740-8066 | Ccs Millersville - Medicaid Facility 8638 Veterans Hwy Ste 301 Millersville MD 21108-1422 Ph: (410) 740-8066 |
| NPI Number | 1053718981 |
|---|---|
| Provider Enumeration Date | 11/20/2014 |
| Last Update Date | 10/28/2021 |
| Certification Date | 10/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053718981 | NPI | - | NPPES |
| 4231881-03 | Medicaid | MD |
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