Provider Demographics
NPI:1437711751
Name:ORCHARD COMMUNITY SERVICES LLC
Entity Type:Organization
Organization Name:ORCHARD COMMUNITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MIRANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-893-7012
Mailing Address - Street 1:2605 BEECH ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-8851
Mailing Address - Country:US
Mailing Address - Phone:845-893-7012
Mailing Address - Fax:
Practice Address - Street 1:2605 BEECH ORCHARD LN
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-8851
Practice Address - Country:US
Practice Address - Phone:845-893-7012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health