Healthcare Provider Details

I. General information

NPI: 1669685400
Provider Name (Legal Business Name): UNIVERSAL HEALTHCARE MANAGEMENT SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 10/24/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5410 INDIAN HWY SUITE 211
OXON HILL MD
20745
US

IV. Provider business mailing address

8708 KITTAMA DR
CLINTON MD
20735-3180
US

V. Phone/Fax

Practice location:
  • Phone: 202-439-3960
  • Fax:
Mailing address:
  • Phone: 202-439-3960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. WILLIAM FRANK PATTERSON
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 301-385-1175