Healthcare Provider Details

I. General information

NPI: 1639532443
Provider Name (Legal Business Name): SMART FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 03/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 MERCANTILE LN STE 260
LARGO MD
20774-5341
US

IV. Provider business mailing address

1400 MERCANTILE LN STE 260
LARGO MD
20774-5341
US

V. Phone/Fax

Practice location:
  • Phone: 301-812-4055
  • Fax: 240-582-5939
Mailing address:
  • Phone: 301-812-4055
  • Fax: 240-582-5939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. CRYSTALL MICHELL HILL
Title or Position: PRESIDENT
Credential: SOCIAL WORKER
Phone: 301-812-4055