Healthcare Provider Details

I. General information

NPI: 1700012101
Provider Name (Legal Business Name): FRONTLINE COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2009
Last Update Date: 12/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11720 BELTSVILLE DRIVE #700
BELTSVILLE MD
20705
US

IV. Provider business mailing address

11720 BELTSVILLE DRIVE #700
BELTSVILLE MD
20705
US

V. Phone/Fax

Practice location:
  • Phone: 301-588-0246
  • Fax: 301-588-0222
Mailing address:
  • Phone: 301-588-0246
  • Fax: 301-588-0222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License NumberD06690515
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DITTU ABRAHAM
Title or Position: PRESIDENT
Credential: M.A., LLB
Phone: 301-588-0246