Provider Demographics
NPI:1356033609
Name:BAC HEALTH SERVICES LLC
Entity type:Organization
Organization Name:BAC HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAFIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-565-9022
Mailing Address - Street 1:14300 CHERRY LANE CT STE 108
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4978
Mailing Address - Country:US
Mailing Address - Phone:240-713-8080
Mailing Address - Fax:240-993-5700
Practice Address - Street 1:14300 CHERRY LANE CT STE 108
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4978
Practice Address - Country:US
Practice Address - Phone:240-713-8080
Practice Address - Fax:240-993-5700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-24
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)