Provider Demographics
NPI:1518721257
Name:THE UNFOLDING ROOM, LLC
Entity Type:Organization
Organization Name:THE UNFOLDING ROOM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LCPC
Authorized Official - Prefix:MR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:III
Authorized Official - Credentials:LCPC
Authorized Official - Phone:301-357-2824
Mailing Address - Street 1:7635 CHESHAM CT
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-4457
Mailing Address - Country:US
Mailing Address - Phone:301-357-2824
Mailing Address - Fax:
Practice Address - Street 1:7635 CHESHAM CT
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-4457
Practice Address - Country:US
Practice Address - Phone:301-357-2824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)