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NPI Code Detail

MEDICARE: LDS FAMILY SERVICES

MEDICARE: LDS FAMILY SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)00319MA

General Provider Information

NPI Number : 1033381892
Entity Type Code : Organization
Provider Name (Legal Business Name) : LDS FAMILY SERVICES
Provider Business Mailing Address
First Line : 172 THOMAS JOHNSON DRIVE
Second Line : SUITE 200
City : FREDERICK
State : MD
Zip : 21702-4404
Country : US
Telephone Number : 301-694-5896
Fax Number : 301-662-8737
Provider Business Practice Location Address
First Line : 172 THOMAS JOHNSON DRIVE
Second Line : SUITE 200
City : FREDERICK
State : MD
Zip : 21702-4404
Country : US
Telephone Number : 301-694-5896
Fax Number : 301-662-8737
Authorized Official
Title or Position : AGENCY DIRECTOR
Name : MR. KYLE K OSWALD
Credential : LCSW
Telephone Number : 301-694-5896
Provider Enumeration Date : 04/01/2008
Last Update Date : 04/01/2008

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Directions to “LDS FAMILY SERVICES ” Practice Location

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