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General NPI Number Information
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NPI Number | 1821444852
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Entity Type | Organization
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Legal Business Name | ISPAR FOUNDATION, INC.
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Dates
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Enumeration Date | 05/09/2016
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Last Update Date | 05/09/2016
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Provider Practice Location Address
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Address Line | 4635 RIVER RD
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City | BETHESDA
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State | MD
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Zip | 20816-3031
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Country | US
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Telephone | 240-997-1964
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Fax |
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Provider Business Mailing Address
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Address Line | 5916 VANDEGRIFT AVE
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City | ROCKVILLE
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State | MD
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Zip | 20851-1940
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. VICTORIA KARAKCHEYEVA
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Credential |
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Telephone | 240-997-1964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | MH-1974
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License Number State | MD
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