Healthcare Provider Details

I. General information

NPI: 1306654280
Provider Name (Legal Business Name): ROBERT A. PASCAL YOUTH & FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2024
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 COMMUNITY PL
CROWNSVILLE MD
21032-2034
US

IV. Provider business mailing address

PO BOX 180
ODENTON MD
21113-0180
US

V. Phone/Fax

Practice location:
  • Phone: 410-571-4500
  • Fax:
Mailing address:
  • Phone: 410-975-0067
  • Fax: 410-975-0204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY LAMB
Title or Position: DIRECTOR OF ADMINISTRATION
Credential:
Phone: 410-975-0067