Healthcare Provider Details

I. General information

NPI: 1326437963
Provider Name (Legal Business Name): A PLACE FOR ME, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2015
Last Update Date: 01/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4670 WILLIAMS WHARF RD
SAINT LEONARD MD
20685-3044
US

IV. Provider business mailing address

4670 WILLIAMS WHARF RD
SAINT LEONARD MD
20685-3044
US

V. Phone/Fax

Practice location:
  • Phone: 202-494-8838
  • Fax: 443-295-7814
Mailing address:
  • Phone: 202-494-8838
  • Fax: 443-295-7814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT TERRY GRAHAM
Title or Position: PRESIDENT/CEO
Credential:
Phone: 202-494-8838