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General NPI Number Information
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NPI Number | 1366716326
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Entity Type | Organization
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Legal Business Name | INSIGHT THERAPEUTIC SERVICES INC
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Dates
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Enumeration Date | 03/08/2012
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Last Update Date | 03/08/2012
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Provider Practice Location Address
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Address Line | 1282 SMALLWOOD DR W SUITE 281
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City | WALDORF
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State | MD
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Zip | 20603-4732
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Country | US
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Telephone | 301-503-0511
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Fax |
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Provider Business Mailing Address
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Address Line | 1282 SMALLWOOD DR W SUITE 281
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City | WALDORF
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State | MD
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Zip | 20603-4732
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Country | US
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Telephone | 301-503-0511
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | PORTIA MAILLARD-LAWS
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Credential |
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Telephone | 301-503-0511
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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 | LC4088
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License Number State | MD
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