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NPI Code Detail

MEDICARE: FAMILY SERVICE FOUNDATION, INC

MEDICARE: FAMILY SERVICE FOUNDATION, 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
1103TR0400XRehabilitation Psychologist4163MD

General Provider Information

NPI Number : 1457675548
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY SERVICE FOUNDATION, INC
Provider Business Mailing Address
First Line : 5301 76TH AVE
Second Line :
City : LANDOVER HILLS
State : MD
Zip : 20784-1703
Country : US
Telephone Number : 301-459-2121
Fax Number : 301-918-9757
Provider Business Practice Location Address
First Line : 5301 76TH AVE
Second Line :
City : LANDOVER
State : MD
Zip : 20784-1703
Country : US
Telephone Number : 301-459-2121
Fax Number : 301-918-9757
Authorized Official
Title or Position : BILLING MANAGER
Name : DAPHNE SMITH
Credential :
Telephone Number : 301-459-2121
Provider Enumeration Date : 03/18/2010
Last Update Date : 05/18/2012

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Directions to “FAMILY SERVICE FOUNDATION, INC ” Practice Location

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