MEDICARE: ROBERT A. PASCAL YOUTH AND FAMILY SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	07545	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LL38	OTHER	MD	BCBS GROUP NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134338015
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT A. PASCAL YOUTH AND FAMILY SERVICES, INC.

Provider Business Mailing Address
First Line	:	741 ANNAPOLIS RD
Second Line	:
City	:	GAMBRILLS
State	:	MD
Zip	:	21054-1308
Country	:	US
Telephone Number	:	410-975-0067
Fax Number	:	410-975-0204

Provider Business Practice Location Address
First Line	:	741 ANNAPOLIS RD
Second Line	:
City	:	GAMBRILLS
State	:	MD
Zip	:	21054-1308
Country	:	US
Telephone Number	:	410-975-0067
Fax Number	:

Authorized Official
Title or Position	:	DOA
Name	:	KIMBERLY LAMB
Credential	:
Telephone Number	:	410-975-0067

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	11/14/2024

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