Provider Demographics
NPI:1467194134
Name:WE ARE ONE FAMILY HEALTH SERVICES OF MARYLAND, LLC
Entity Type:Organization
Organization Name:WE ARE ONE FAMILY HEALTH SERVICES OF MARYLAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:SYLVESTER
Authorized Official - Last Name:MATHIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-274-6689
Mailing Address - Street 1:1 E CHASE ST STE 1140
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-2565
Mailing Address - Country:US
Mailing Address - Phone:443-564-4983
Mailing Address - Fax:
Practice Address - Street 1:1 E CHASE ST STE 1140
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2565
Practice Address - Country:US
Practice Address - Phone:443-564-4983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health