Provider Demographics
NPI:1821237561
Name:SERVING FROM THE HEART
Entity Type:Organization
Organization Name:SERVING FROM THE HEART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CISLYN
Authorized Official - Middle Name:DEEN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:240-370-5712
Mailing Address - Street 1:PO BOX 3167
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20709-3167
Mailing Address - Country:US
Mailing Address - Phone:240-370-5712
Mailing Address - Fax:
Practice Address - Street 1:13119 LARCHDALE RD
Practice Address - Street 2:APT 5
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1741
Practice Address - Country:US
Practice Address - Phone:240-370-5712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities