Healthcare Provider Details

I. General information

NPI: 1275130965
Provider Name (Legal Business Name): ROBERT A. PASCAL YOUTH AND FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2020
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 COMMUNITY PL
CROWNSVILLE MD
21032-2034
US

IV. Provider business mailing address

43 COMMUNITY PL
CROWNSVILLE MD
21032-2034
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL

VIII. Authorized Official

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