Provider Demographics
NPI:1790938736
Name:THOMAS ASSOCIATES FOUNDATION, INC
Entity Type:Organization
Organization Name:THOMAS ASSOCIATES FOUNDATION, INC
Other - Org Name:BRIGHT FUTURES CLINICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE V.P.
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:443-661-1301
Mailing Address - Street 1:825 N HAMMONDS FERRY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-1355
Mailing Address - Country:US
Mailing Address - Phone:410-789-2635
Mailing Address - Fax:410-789-2767
Practice Address - Street 1:825 N HAMMONDS FERRY RD
Practice Address - Street 2:SUITE A
Practice Address - City:LINTHICUM
Practice Address - State:MD
Practice Address - Zip Code:21090-1355
Practice Address - Country:US
Practice Address - Phone:410-789-2635
Practice Address - Fax:410-789-2767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4048261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health