Healthcare Provider Details
I. General information
NPI: 1326377318
Provider Name (Legal Business Name): METRO FAMILY SUPPORT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/22/2009
Last Update Date: 12/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12022 BION DR
FT WASHINGTON MD
20744-5105
US
IV. Provider business mailing address
12022 BION DR
FT WASHINGTON MD
20744-5105
US
V. Phone/Fax
- Phone: 301-395-8055
- Fax:
- Phone: 301-395-8055
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 252Y00000X |
| Taxonomy | Early Intervention Provider Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JAMES
COLBERT
JR.
Title or Position: CEO
Credential:
Phone: 301-395-8055