Healthcare Provider Details

I. General information

NPI: 1841847241
Provider Name (Legal Business Name): IMPERIAL HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2019
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E NAYLOR MILL RD UNIT F
SALISBURY MD
21804-2256
US

IV. Provider business mailing address

547 RIVERSIDE DR STE A
SALISBURY MD
21801-5369
US

V. Phone/Fax

Practice location:
  • Phone: 410-546-4659
  • Fax:
Mailing address:
  • Phone: 410-546-4659
  • Fax: 410-546-4673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EMELDA FRI NJEI
Title or Position: ADMINISTRATOR
Credential:
Phone: 410-572-4738