Provider Demographics
NPI:1659680460
Name:MARYLAND FAMILY HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:MARYLAND FAMILY HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-315-7996
Mailing Address - Street 1:517 ELLISON CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-6111
Mailing Address - Country:US
Mailing Address - Phone:202-315-7996
Mailing Address - Fax:
Practice Address - Street 1:517 ELLISON CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-6111
Practice Address - Country:US
Practice Address - Phone:202-315-7996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health