Provider Demographics
NPI:1821579582
Name:MARYLAND CENTER FOR FAMILIY GUIDANCE
Entity Type:Organization
Organization Name:MARYLAND CENTER FOR FAMILIY GUIDANCE
Other - Org Name:MARYLAND CENTER FOR FAMILIY GUIDANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:DORSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-433-7084
Mailing Address - Street 1:158 BARNSFIELD CT
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2720
Mailing Address - Country:US
Mailing Address - Phone:804-433-7084
Mailing Address - Fax:
Practice Address - Street 1:158 BARNSFIELD CT
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-2720
Practice Address - Country:US
Practice Address - Phone:804-433-7084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health