Provider Demographics
NPI:1821440009
Name:MULTIDIMENSIONAL COMMUNITY HEALTH SERVICES INC
Entity Type:Organization
Organization Name:MULTIDIMENSIONAL COMMUNITY HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ABRAHAM LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-449-9991
Mailing Address - Street 1:7841 AMERICANA CIR
Mailing Address - Street 2:201
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-7803
Mailing Address - Country:US
Mailing Address - Phone:443-449-9991
Mailing Address - Fax:410-768-3158
Practice Address - Street 1:515 E JOPPA RD
Practice Address - Street 2:100/104
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5418
Practice Address - Country:US
Practice Address - Phone:410-337-0938
Practice Address - Fax:410-337-2104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLPG7130302F00000X
MDLGP7130302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
No302R00000XManaged Care OrganizationsHealth Maintenance Organization