Healthcare Provider Details

I. General information

NPI: 1053100610
Provider Name (Legal Business Name): LUCENTRA CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5457 TWIN KNOLLS RD STE 300-N18
COLUMBIA MD
21045-3259
US

IV. Provider business mailing address

7903 ORION CIR UNIT 360
LAUREL MD
20724-3112
US

V. Phone/Fax

Practice location:
  • Phone: 301-265-6441
  • Fax:
Mailing address:
  • Phone: 301-265-6441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ALI MOHAMMADABADI
Title or Position: MANAGING MEMBER
Credential:
Phone: 301-265-6441