Provider Demographics
NPI:1437273372
Name:GUIDE PROGRAM, INC
Entity Type:Organization
Organization Name:GUIDE PROGRAM, INC
Other - Org Name:GUIDE INDEPENDENCE PRP - PRINCE GEORGE'S
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR & PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:K
Authorized Official - Last Name:BIRDSONG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-549-3602
Mailing Address - Street 1:8643 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-6200
Mailing Address - Country:US
Mailing Address - Phone:301-549-3602
Mailing Address - Fax:301-549-3605
Practice Address - Street 1:5508 KAREN ELAINE DR
Practice Address - Street 2:824
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-4131
Practice Address - Country:US
Practice Address - Phone:301-459-8220
Practice Address - Fax:301-577-1756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)