Provider Demographics
NPI:1518958669
Name:THE FAMILY SERVICES AGENCY, INC.
Entity Type:Organization
Organization Name:THE FAMILY SERVICES AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ELWOOD
Authorized Official - Last Name:HARR
Authorized Official - Suffix:
Authorized Official - Credentials:MLS, MBA
Authorized Official - Phone:301-840-3202
Mailing Address - Street 1:610 E DIAMOND AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-5321
Mailing Address - Country:US
Mailing Address - Phone:301-840-2000
Mailing Address - Fax:301-840-9621
Practice Address - Street 1:610 E DIAMOND AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-5321
Practice Address - Country:US
Practice Address - Phone:301-840-2000
Practice Address - Fax:301-840-9621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13342 OMHC LICENSE251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
655013Medicare ID - Type UnspecifiedMEDICARE