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General NPI Number Information
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NPI Number | 1609690569
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Entity Type | Organization
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Legal Business Name | ADVANCED CENTERS FOR THE SPECIALLY ENABLED LLC
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Dates
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Enumeration Date | 11/08/2024
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 9125 GUILFORD RD STE 104
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City | COLUMBIA
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State | MD
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Zip | 21046-3459
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Country | US
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Telephone | 410-777-9063
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Fax |
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Provider Business Mailing Address
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Address Line | 9125 GUILFORD RD STE 104
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City | COLUMBIA
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State | MD
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Zip | 21046-3459
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Country | US
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Telephone | 410-777-9063
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. RENE PALACIOS JR.
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Credential |
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Telephone | 410-777-9063
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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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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