Provider Demographics
NPI:1780641928
Name:FAMILY SERVICES, INC
Entity Type:Organization
Organization Name:FAMILY SERVICES, INC
Other - Org Name:FAMILY SERVICES AGENCY, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KYLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLEAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-840-3267
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:2006-05-01
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD816700100Medicaid
MD655013Medicare ID - Type Unspecified