Provider Demographics
NPI:1184028219
Name:POTOMAC CASE MANAGEMENT SERVICES
Entity Type:Organization
Organization Name:POTOMAC CASE MANAGEMENT SERVICES
Other - Org Name:POTOMAC COMMUNITY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:R
Authorized Official - Last Name:JOHNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-791-3087
Mailing Address - Street 1:324 E ANTIETAM ST STE 301
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5768
Mailing Address - Country:US
Mailing Address - Phone:301-791-3087
Mailing Address - Fax:
Practice Address - Street 1:1446 W PATRICK ST STE 16
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-3201
Practice Address - Country:US
Practice Address - Phone:443-244-5187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POTOMAC CASE MANAGEMENT SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-17
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management