MEDICARE: THE FAMILY SERVICES AGENCY, 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	251V00000X	Voluntary or Charitable Agency	13342 OMHC LICENSE	MD

General Provider Information

NPI Number	:	1518958669
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE FAMILY SERVICES AGENCY, INC.

Provider Business Mailing Address
First Line	:	610 E DIAMOND AVE
Second Line	:	SUITE 100
City	:	GAITHERSBURG
State	:	MD
Zip	:	20877-5321
Country	:	US
Telephone Number	:	301-840-2000
Fax Number	:	301-840-9621

Provider Business Practice Location Address
First Line	:	610 E DIAMOND AVE
Second Line	:	SUITE 100
City	:	GAITHERSBURG
State	:	MD
Zip	:	20877-5321
Country	:	US
Telephone Number	:	301-840-2000
Fax Number	:	301-840-9621

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. THOMAS ELWOOD HARR
Credential	:	M.L.S., M.B.A.
Telephone Number	:	301-840-3202

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	07/21/2022

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