Healthcare Provider Details

I. General information

NPI: 1932959046
Provider Name (Legal Business Name): INTOUCH M SPA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 03/25/2024
Certification Date: 03/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7245 HANOVER PKWY STE A
GREENBELT MD
20770-3607
US

IV. Provider business mailing address

7245 HANOVER PKWY STE A
GREENBELT MD
20770-3607
US

V. Phone/Fax

Practice location:
  • Phone: 301-818-2645
  • Fax:
Mailing address:
  • Phone: 301-818-2645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. EBONI REED
Title or Position: CEO
Credential: R03202
Phone: 407-300-4346