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General NPI Number Information
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NPI Number | 1265729677
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC LIVING FOR FAMILIES INC.
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 03/02/2017
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Provider Practice Location Address
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Address Line | 1837 PULASKI HIGHWAY
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City | EDGEWOOD
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State | MD
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Zip | 21040-1446
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Country | US
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Telephone | 410-366-1151
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Fax | 410-366-0032
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Provider Business Mailing Address
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Address Line | 3425 SINCLAIR LN
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City | BALTIMORE
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State | MD
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Zip | 21213-2030
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Country | US
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Telephone | 410-366-1151
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Fax | 410-366-0032
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Authorized Official
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Title or Position | DIRECTOR OF HR & ADMINISTRATION
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Name | NICOLE RAYFIELD
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Credential |
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Telephone | 410-366-1151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 511 5 MH 785
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License Number State | MD
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