Provider Demographics
NPI:1083379168
Name:NEXT LEVEL FAMILY SERVICES, LLC
Entity Type:Organization
Organization Name:NEXT LEVEL FAMILY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:KELLAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-221-3656
Mailing Address - Street 1:4200 EDMONDSON AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-1612
Mailing Address - Country:US
Mailing Address - Phone:443-221-3656
Mailing Address - Fax:
Practice Address - Street 1:4200 EDMONDSON AVE STE 206
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-1612
Practice Address - Country:US
Practice Address - Phone:443-221-3656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health