Healthcare Provider Details

I. General information

NPI: 1609310101
Provider Name (Legal Business Name): CONTEMPORARY FAMILY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2016
Last Update Date: 12/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 WILKENS AVE SUITE 308/208
BALTIMORE MD
21229-5213
US

IV. Provider business mailing address

3455 WILKENS AVE SUITE 308/208
BALTIMORE MD
21229-5213
US

V. Phone/Fax

Practice location:
  • Phone: 410-525-8601
  • Fax:
Mailing address:
  • Phone: 410-525-8601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number906038
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number906038
License Number StateMD

VIII. Authorized Official

Name: DR. JOHN LEWIS MONROE JR.
Title or Position: CEO
Credential: DSW
Phone: 240-375-1957