Provider Demographics
NPI:1326694217
Name:IFCS OF MARYLAND, INC. A/K/A INSTITUTE FOR FAMILY CENTERED SERVICES, I
Entity Type:Organization
Organization Name:IFCS OF MARYLAND, INC. A/K/A INSTITUTE FOR FAMILY CENTERED SERVICES, I
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP & SR. ASST GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:RODENBERG-ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-836-2234
Mailing Address - Street 1:2525 LORD BALTIMORE DR STE H
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2671
Mailing Address - Country:US
Mailing Address - Phone:410-455-4601
Mailing Address - Fax:
Practice Address - Street 1:560 RIVERSIDE DR STE B206
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-4701
Practice Address - Country:US
Practice Address - Phone:410-548-5921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-15
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health