Provider Demographics
NPI:1245910132
Name:AZURE CARE CENTER
Entity type:Organization
Organization Name:AZURE CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLIENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CLIENT
Authorized Official - Middle Name:
Authorized Official - Last Name:SERVICES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-429-8732
Mailing Address - Street 1:9701 APOLLO DR STE 100
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-4785
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9701 APOLLO DR STE 100
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-4785
Practice Address - Country:US
Practice Address - Phone:844-429-8732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty