Provider Demographics
NPI:1174752984
Name:FIELDS AND FIELDS TREATMENT CENTER LLC
Entity type:Organization
Organization Name:FIELDS AND FIELDS TREATMENT CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:E
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:240-788-6125
Mailing Address - Street 1:13602 GENTRY CT
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1330
Mailing Address - Country:US
Mailing Address - Phone:240-832-4007
Mailing Address - Fax:
Practice Address - Street 1:1450 MERCANTILE LN STE 221
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5376
Practice Address - Country:US
Practice Address - Phone:240-788-6125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility