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General NPI Number Information
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NPI Number | 1255455192
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Entity Type | Organization
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Legal Business Name | GUIDE PROGRAM, INC.
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Dates
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Enumeration Date | 03/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 18321 LOST KNIFE CIR 101
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City | GAITHERSBURG
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State | MD
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Zip | 20886-0305
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Country | US
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Telephone | 301-948-1000
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Fax | 301-937-4378
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Provider Business Mailing Address
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Address Line | 8643 CHERRY LN
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City | LAUREL
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State | MD
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Zip | 20707-6200
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Country | US
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Telephone | 301-549-3602
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Fax | 301-549-3605
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR & PRESIDENT
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Name | MR. SCOTT K. BIRDSONG
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Credential | LCSW-C
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Telephone | 301-549-3602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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