Provider Demographics
NPI: | 1144596198 |
---|---|
Name: | CONTEMPORARY FAMILY SERVICES, INC. |
Entity Type: | Organization |
Organization Name: | CONTEMPORARY FAMILY SERVICES, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | JOHN |
Authorized Official - Middle Name: | LEWIS |
Authorized Official - Last Name: | MONROE |
Authorized Official - Suffix: | JR |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 240-375-1957 |
Mailing Address - Street 1: | 6525 BELCREST RD |
Mailing Address - Street 2: | SUITE SUITE G40 |
Mailing Address - City: | HYATTSVILLE |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 20782-2003 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 240-375-1957 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 200 N THOMAS DR STE 1 |
Practice Address - Street 2: | |
Practice Address - City: | SHREVEPORT |
Practice Address - State: | LA |
Practice Address - Zip Code: | 71107-6503 |
Practice Address - Country: | US |
Practice Address - Phone: | 318-424-8345 |
Practice Address - Fax: | 318-424-4417 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-03-23 |
Last Update Date: | 2019-01-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
LA | 2203783493 | 101YP2500X, 324500000X |
DC | 251B00000X, 251C00000X, 251S00000X, 261QM0801X, 320800000X, 320900000X, 324500000X, 3245S0500X | |
251S00000X, 320900000X, 324500000X, 3245S0500X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health | ||
No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
No | 251B00000X | Agencies | Case Management | ||
No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | ||
No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | |
No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | Group - Multi-Specialty | |
No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | Group - Multi-Specialty | |
No | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | ||
No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children |