Provider Demographics
NPI:1497471205
Name:ABREAST THERAPEUTIC CENTER, INC
Entity Type:Organization
Organization Name:ABREAST THERAPEUTIC CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ABAYOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:SOKOYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-764-5180
Mailing Address - Street 1:9418 ANNAPOLIS RD STE 202
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3053
Mailing Address - Country:US
Mailing Address - Phone:240-764-5180
Mailing Address - Fax:240-467-3981
Practice Address - Street 1:9418 ANNAPOLIS RD STE 202
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3053
Practice Address - Country:US
Practice Address - Phone:240-764-5180
Practice Address - Fax:240-467-3981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-13
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children