Healthcare Provider Details
I. General information
NPI: 1780129239
Provider Name (Legal Business Name): CONTEMPORARY FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/19/2016
Last Update Date: 12/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20400 OBSERVATION DR SUITE 103
GERMANTOWN MD
20876-4085
US
IV. Provider business mailing address
20400 OBSERVATION DR SUITE 103
GERMANTOWN MD
20876-4085
US
V. Phone/Fax
- Phone: 240-375-1957
- Fax: 240-686-1972
- Phone: 240-375-1957
- Fax: 240-686-1972
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 324500000X |
| Taxonomy | Substance Abuse Rehabilitation Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3245S0500X |
| Taxonomy | Children's Substance Abuse Rehabilitation Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHN
LEWIS
MONROE
JR.
Title or Position: CEO
Credential: DSW
Phone: 240-375-1957