Provider Demographics
NPI:1851675946
Name:CHILDREN ACHIEVING MAXIMUM POTENTIAL, INC.
Entity Type:Organization
Organization Name:CHILDREN ACHIEVING MAXIMUM POTENTIAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:DE JONG
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:301-591-9776
Mailing Address - Street 1:2275 RESEARCH BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3268
Mailing Address - Country:US
Mailing Address - Phone:301-591-9776
Mailing Address - Fax:301-263-6870
Practice Address - Street 1:2275 RESEARCH BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3268
Practice Address - Country:US
Practice Address - Phone:301-591-9776
Practice Address - Fax:301-263-6870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD541497100Medicaid