Provider Demographics
NPI:1043803604
Name:LOOKING FORWARD CRISIS RESIDENTIAL, INC
Entity Type:Organization
Organization Name:LOOKING FORWARD CRISIS RESIDENTIAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:HEBRON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:202-740-7311
Mailing Address - Street 1:8447 ROLLING RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-1932
Mailing Address - Country:US
Mailing Address - Phone:202-740-7311
Mailing Address - Fax:
Practice Address - Street 1:8447 ROLLING RIDGE CT
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-1932
Practice Address - Country:US
Practice Address - Phone:202-740-7311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness