Provider Demographics
NPI:1477108785
Name:PANATECHS LLC
Entity Type:Organization
Organization Name:PANATECHS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SOZY
Authorized Official - Middle Name:
Authorized Official - Last Name:MSINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-258-3344
Mailing Address - Street 1:14115 PORRINGER CT
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-2062
Mailing Address - Country:US
Mailing Address - Phone:202-258-3344
Mailing Address - Fax:
Practice Address - Street 1:14115 PORRINGER CT
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-2062
Practice Address - Country:US
Practice Address - Phone:202-258-3344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-04
Last Update Date:2019-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities