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General NPI Number Information
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NPI Number | 1003537994
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Entity Type | Organization
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Legal Business Name | PFTSPORTS LLC
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Dates
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Enumeration Date | 09/08/2022
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 901 BRIGHTSEAT RD
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City | LANDOVER
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State | MD
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Zip | 20785-4725
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Country | US
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Telephone | 240-286-9713
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Fax |
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Provider Business Mailing Address
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Address Line | 901 BRIGHTSEAT RD
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City | LANDOVER
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State | MD
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Zip | 20785-4725
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Country | US
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Telephone | 240-286-9713
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NDUBUISI OKAFOR
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Credential |
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Telephone | 240-286-9713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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