Provider Demographics
NPI:1013327048
Name:AMERICAN FAMILY MATTERS LLC
Entity Type:Organization
Organization Name:AMERICAN FAMILY MATTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:Z
Authorized Official - Last Name:RUNNELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-620-1999
Mailing Address - Street 1:129 W PATRICK ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-5551
Mailing Address - Country:US
Mailing Address - Phone:301-620-1999
Mailing Address - Fax:301-620-7672
Practice Address - Street 1:231 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-1605
Practice Address - Country:US
Practice Address - Phone:301-620-1999
Practice Address - Fax:301-620-7672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22951609251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health