Healthcare Provider Details

I. General information

NPI: 1194954347
Provider Name (Legal Business Name): VILLAGE FAMILY NETWORK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 07/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 MERCANTILE LN STE 206
UPPER MARLBORO MD
20774-5340
US

IV. Provider business mailing address

12703 THRUSH PL STE A
UPPER MARLBORO MD
20772-5283
US

V. Phone/Fax

Practice location:
  • Phone: 301-322-2692
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateMD

VIII. Authorized Official

Name: HASSAN SABREE
Title or Position: CEO
Credential: MHP
Phone: 301-322-2692