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General NPI Number Information
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NPI Number | 1508650730
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Entity Type | Organization
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Legal Business Name | FIRST HEALTH SERVICES LLC
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Dates
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Enumeration Date | 04/04/2025
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 4411 SOUTHERN AVE
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City | CAPITOL HEIGHTS
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State | MD
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Zip | 20743-5639
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Country | US
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Telephone | 240-633-6156
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Fax |
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Provider Business Mailing Address
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Address Line | 4411 SOUTHERN AVE
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City | CAPITOL HEIGHTS
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State | MD
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Zip | 20743-5639
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Country | US
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Telephone | 240-633-6156
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. STANISLUS E EBAN
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Credential | PHD
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Telephone | 240-533-6152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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