Provider Demographics
NPI:1225660970
Name:STEADFAST CARE SERVICES,LLC
Entity Type:Organization
Organization Name:STEADFAST CARE SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:AKEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-206-8084
Mailing Address - Street 1:18345 ALLSPICE DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-2012
Mailing Address - Country:US
Mailing Address - Phone:202-415-6629
Mailing Address - Fax:
Practice Address - Street 1:5303 KINGSBROOK DR
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-2806
Practice Address - Country:US
Practice Address - Phone:202-415-6629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities