Provider Demographics
NPI:1205607488
Name:FIRST OPTION BEHAVIORAL SUPPORT
Entity type:Organization
Organization Name:FIRST OPTION BEHAVIORAL SUPPORT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:CHINYERE
Authorized Official - Last Name:MADUBUKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-334-1121
Mailing Address - Street 1:12902 OLD CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4616
Mailing Address - Country:US
Mailing Address - Phone:240-334-1121
Mailing Address - Fax:
Practice Address - Street 1:12902 OLD CHAPEL RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4616
Practice Address - Country:US
Practice Address - Phone:240-334-1121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIRST OPTION LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-16
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive Care
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No385H00000XRespite Care FacilityRespite Care
No385HR2050XRespite Care FacilityRespite CareRespite Care Camp
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child