Provider Demographics
NPI:1508621772
Name:M&T HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:M&T HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:
Authorized Official - Last Name:EKEMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-735-6036
Mailing Address - Street 1:9201 EDGEWORTH DR UNIT 3412
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20791-7505
Mailing Address - Country:US
Mailing Address - Phone:301-735-6036
Mailing Address - Fax:
Practice Address - Street 1:9201 EDGEWORTH DR UNIT 3412
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20791-7505
Practice Address - Country:US
Practice Address - Phone:301-735-6036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)