MEDICARE: FIRST HEALTH SERVICES LLC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1508650730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	4411 SOUTHERN AVE
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-5639
Country	:	US
Telephone Number	:	240-633-6156
Fax Number	:

Provider Business Practice Location Address
First Line	:	4411 SOUTHERN AVE
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-5639
Country	:	US
Telephone Number	:	240-633-6156
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. STANISLUS E EBAN
Credential	:	PHD
Telephone Number	:	240-533-6152

Provider Enumeration Date	:	04/04/2025
Last Update Date	:	04/04/2025

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Directions to “FIRST HEALTH SERVICES LLC ” Practice Location

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